text: V̇O max/peak is widely used as an indicator of cardiorespiratory fitness (CRF) in select groups of athletes or, rarely, in people under assessment for disease risk. In 2016, the American Heart Association (AHA) published a scientific statement recommending that CRF  quantifiable as V̇O max/peak  be regularly assessed and used as a clinical vital sign; ergometry (exercise wattage measurement) may be used if VO is unavailable. This statement was based on evidence that lower fitness levels are associated with a higher risk of cardiovascular disease, all-cause mortality, and mortality rates. In addition to risk assessment, the AHA recommendation cited the value for measuring fitness to validate exercise prescriptions, physical activity counseling, and improve both management and health of people being assessed.
  A 2023 meta-analysis of observational cohort studies showed an inverse and independent association between V̇O max and all-cause mortality risk. Every one metabolic equivalent increase in estimated cardiorespiratory fitness was associated with an 11% reduction in mortality. The top third of V̇O max scores represented a 45% lower mortality in people compared with the lowest third.
  As of 2023, V̇O max is rarely employed in routine clinical practice to assess cardiorespiratory fitness or mortality due to its considerable demand for resources and costs.