Fitness Testing for Heart Disease Prevention

Heart disease remains the leading cause of death in the United States. Major risk factors include:

• Non-Modifiable Risks:
  • • Age (men 45 and older, women 55 and older)
  • • Family history of early heart disease (father or brother before age 55, mother or sister before age 65)
  • • Male sex (though risk equalizes for women after menopause)
• Modifiable Risks:
  • • High blood pressure (above 130/80 mmHg)
  • • High LDL cholesterol (above 100 mg/dL)
  • • Low HDL cholesterol (below 40 mg/dL men, below 50 mg/dL women)
  • • Smoking or tobacco use
  • • Diabetes or pre-diabetes
  • • Obesity (BMI above 30) or abdominal obesity
  • • Physical inactivity
  • • Poor diet
  • • Excessive alcohol consumption

VO₂ max testing directly addresses the physical inactivity risk factor and provides data to help manage several others (blood pressure, weight, blood sugar).

Regular physical activity protects your cardiovascular system through multiple mechanisms:

• Improves Heart Function: Strengthens the heart muscle, increases stroke volume (blood pumped per beat), and lowers resting heart rate
• Enhances Blood Vessel Health: Improves endothelial function (inner lining of arteries), increases arterial flexibility, and promotes growth of new small blood vessels (collateral circulation)
• Reduces Blood Pressure: Regular aerobic exercise can lower blood pressure by 5 to 10 mmHg in people with hypertension
• Improves Lipid Profile: Raises HDL (good) cholesterol, lowers triglycerides, and may favorably affect LDL particle size
• Improves Insulin Sensitivity: Helps prevent or manage diabetes, a major heart disease risk factor
• Reduces Inflammation: Lowers inflammatory markers like C-reactive protein associated with atherosclerosis
• Aids Weight Management: Helps achieve and maintain healthy body weight, reducing strain on the heart
• Improves Autonomic Balance: Enhances parasympathetic (rest and digest) nervous system activity, associated with lower cardiac risk

VO₂ max testing provides comprehensive cardiovascular fitness assessment:

• Establish Fitness Baseline: Know your current cardiovascular fitness level. VO₂ max is the gold standard measurement of aerobic capacity
• Assess Cardiovascular Risk: Low fitness is a powerful independent risk factor. Knowing your fitness helps assess overall cardiovascular risk
• Personalized Exercise Zones: Get 5 heart rate zones based on YOUR physiology, not age-based formulas that can be inaccurate by 10 to 20 beats per minute
• Optimal Training Intensity: Learn your Zone 2 (aerobic endurance zone, typically 60 to 70% of maximum heart rate), where you build cardiovascular fitness most effectively
• Safe Exercise Prescription: Know how hard you can safely train, especially important if you have risk factors or are starting exercise later in life
• Track Improvements: Retest every 8 to 12 weeks to measure fitness gains and confirm your training program is working
• Motivation Through Data: Seeing objective improvements in VO₂ max provides powerful motivation to maintain exercise habits

Testing Process: 45 to 60 minute appointment on your choice of equipment (treadmill for runners, bike for cyclists, rower, or stair mill). Same day results with detailed heart rate zones and training recommendations.

VO₂ max testing is valuable for anyone interested in heart disease prevention, especially if you:

• Have family history of heart disease
• Have multiple cardiovascular risk factors (high blood pressure, high cholesterol, diabetes, obesity)
• Are starting a new exercise program and want to train safely
• Want to know your current cardiovascular fitness level
• Are tracking fitness improvements over time
• Are an athlete or active individual monitoring cardiovascular health
• Want objective data to motivate consistent exercise habits

When to Consult Your Physician Before Testing:

• Men 45 and older or women 55 and older starting vigorous exercise program
• Two or more cardiovascular risk factors (see risk factor list above)
• Known heart disease, peripheral vascular disease, or cerebrovascular disease
• Diabetes (Type 1 or Type 2)
• Kidney disease
• Symptoms suggestive of cardiac disease (chest discomfort, unusual shortness of breath, dizziness, fainting)

Your physician may recommend medical stress testing before VO₂ max testing if you are at higher risk. Medical stress tests include ECG monitoring and physician supervision to assess for cardiac ischemia or arrhythmias.

Based on American Heart Association and American College of Cardiology guidelines:

• Aerobic Exercise (Primary Prevention):
  • • Minimum: 150 minutes per week moderate intensity (Zone 2) OR 75 minutes per week vigorous intensity (Zone 4 to 5)
  • • Optimal: 300 minutes per week moderate intensity for greater cardiovascular benefits
  • • Spread throughout the week (e.g., 30 minutes, 5 days per week)
  • • Can be accumulated in bouts of 10 minutes or more
• Resistance Training: 2 days per week targeting all major muscle groups. Helps maintain muscle mass, bone density, and metabolic health
• Reduce Sedentary Time: Break up prolonged sitting every 30 minutes. Even light activity reduces cardiovascular risk

VO₂ max testing eliminates guesswork-you will know exactly what "moderate intensity" and "vigorous intensity" mean for YOUR body based on your actual physiology.

Zone 2 training is the foundation of cardiovascular fitness and heart disease prevention:

• What is Zone 2? Aerobic endurance zone, typically 60 to 70% of maximum heart rate, where you can maintain conversation but are clearly working. This is "moderate intensity" exercise
• Builds Aerobic Base: Increases mitochondrial density, improves fat oxidation, and enhances oxygen delivery to muscles
• Sustainable Long-Term: Easy enough to maintain for 30 to 60 minutes or more, allowing you to accumulate weekly exercise volume
• Low Injury Risk: Lower impact on joints and connective tissue compared to high intensity training
• Most Time-Efficient: Research shows 80% of training in Zone 1 to 2 and only 20% in Zone 4 to 5 produces best cardiovascular adaptations (polarized training)

Most people training on their own exercise too hard (Zone 3 to 4) on easy days and not hard enough on workout days. VO₂ max testing provides precise zones to prevent this common mistake.

Monitor multiple markers with your healthcare provider:

• VO₂ Max: Test every 8 to 12 weeks to track fitness improvements
• Resting Heart Rate: Lower is generally better (40 to 60 bpm is excellent for adults)
• Blood Pressure: Goal below 120/80 mmHg
• Lipid Panel: Total cholesterol, LDL, HDL, triglycerides (annually or per physician recommendation)
• Fasting Glucose and A1C: Screen for diabetes risk
• Body Composition: Waist circumference, BMI, or body fat percentage
• Exercise Log: Track weekly minutes of Zone 2 training and strength sessions

Many cardiovascular risk factors improve with weight loss. RMR testing supports weight management:

• Precise Calorie Needs: Know your exact daily metabolic rate, not estimates
• Safe Weight Loss: Create appropriate 300 to 500 calorie deficit
• Preserve Muscle: Adequate calories and protein prevent muscle loss
• Track Metabolic Health: Retest as weight changes

Performance Pack ($300): Combine VO₂ max and RMR testing (save $25) for comprehensive cardiovascular and metabolic assessment.

Comprehensive heart disease prevention includes:

• Nutrition: Mediterranean diet pattern with vegetables, fruits, whole grains, fish, nuts, olive oil
• Smoking Cessation: Single most important modifiable risk factor if you smoke
• Stress Management: Chronic stress elevates cortisol and inflammation
• Sleep: 7 to 9 hours per night. Poor sleep increases cardiovascular risk
• Alcohol: Limit to moderate consumption (1 drink per day for women, 2 for men maximum)
• Social Connection: Strong social ties are protective for heart health

While Zone 2 is the foundation, higher intensity training (Zone 4 to 5) provides additional benefits:

• Improves VO₂ Max More Rapidly: High intensity interval training (HIIT) is very effective for improving VO₂ max
• Time Efficient: Can get benefits in shorter duration (20 to 30 minutes including recovery)
• Raises Lactate Threshold: Improves ability to sustain higher intensities

Recommended approach: Build aerobic base with Zone 2 for 8 to 12 weeks, then add 1 to 2 high intensity sessions per week while maintaining Zone 2 volume (80/20 polarized training).

Key principles for lifelong cardiovascular health:

• Consistency Matters Most: Regular moderate exercise beats sporadic intense exercise
• Never Too Late: Cardiovascular fitness can improve at any age
• Maintain Fitness: Detraining occurs quickly-maintain regular exercise throughout life
• Retest Periodically: Track fitness every 6 to 12 months to ensure you are maintaining or improving
• Adjust with Age: Training volume and intensity may need modification as you age, but staying active is crucial

VO₂ Max Test: $250

RMR Test: $75

Performance Pack (Both): $300

Fit Evaluations
311 Soquel Ave
Santa Cruz, CA 95062

Behind Hindquarter restaurant (second entrance off Dakota St.)

Phone: 831-400-9227
Email: info@fitevals.com