Chest
Volume 144, Issue 1, July 2013, Pages 241-248
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Original Research
Pulmonary Physiology
Reference Values for Cardiorespiratory Response and Fitness on the Treadmill in a 20- to 85-Year-Old Population

https://doi.org/10.1378/chest.12-1458Get rights and content

Background

Existing reference values for clinical exercise testing have been derived from small nonrandom samples, lacking women and older individuals and some with poor or no maximal end criteria. The objective was to study the cardiorespiratory response during maximal exercise in a representative predominantly Caucasian sample of men and women.

Methods

Nine hundred four randomly sampled men and women, 20 to 85 years old, exercised on a treadmill to exhaustion. Oxygen uptake (

o2), heart rate (HR), BP, blood lactate concentration, and ventilatory variables were measured.

Results

Seven hundred fifty-nine participants met the criteria for an acceptable maximal

o2 (
o2max) based on a respiratory exchange ratio ≥ 1.10 or a Borg score ≥ 17. In the 20- to 29-year-old age group,
o2max (mL/kg/min) was 40.3 (± 7.1) in women and 48.6 (± 9.6) in men. A linear decline (8% per decade) was observed after age 30 years in both sexes. Maximal HR decreased with age by ± 6.3 beats/min per decade. The maximal oxygen pulse was 33% lower in women and decreased significantly with age in both sexes by 5% and 3% per decade for women and men, respectively. Women's maximal ventilation was 66% that of men and decreased with age after 40 to 49 years in both sexes. Breathing reserve was higher and blood lactate was lower in women than in men.

Conclusions

This study establishes reference values for

o2max (absolute, relative to body weight and fat-free weight), maximal HR, oxygen pulse, BP, ventilation, breathing reserve, respiratory exchange ratio, and blood lactate concentration during maximal exercise on treadmill in a large population.

Section snippets

Materials and Methods

This study was part of a multicenter study involving nine regional test centers throughout Norway. The study was approved by the Regional Committee for Medical Ethics (REK Sør-Øst B, S-08046b), the Norwegian Social Science Data Services, and the Norwegian Tax Department. All subjects signed written informed consent forms before participating.

In 2008, 3,485 individuals underwent objective measurements of physical activity with the GT1M accelerometer (ActiGraph, LLC) and completed a questionnaire

Results

This study examined 904 predominantly Caucasian subjects. Eighteen were excluded because of poor health, and 127 did not meet the criteria for maximal effort. Thus, 394 men and 365 women successfully achieved the

o2max (84%). The mean baseline characteristics are shown according to 10-year age cohorts in Table 1 (women) and Table 2 (men).

Table 3, Table 4 show the average cardiopulmonary variables measured at maximal exercise according to 10-year age cohorts for women and men, respectively.

Discussion

This national cohort study presents reference values for the interpretation of CPET derived from a randomly selected sample of 759 apparently healthy men and women aged 20 to 85 years. We have demonstrated that the

o2max relative to body mass is about 25% higher in men than in women, the decline in
o2max (8% per decade) had already started after the first age cohort (20-29 years) and was linear throughout all age cohorts, the women's
emax was 66% that of the men and
emax decreased with age

Conclusions

In summary, this is the first investigation to evaluate a large and well-described population including different maximal cardiorespiratory fitness variables for both men and women on a treadmill across all ages from 20 to 85 years. The statistical analysis focused on the relationship between age and the different physiologic variables used in a typical clinical setting. These results can be used as reference variables during CPET on a treadmill.

Acknowledgments

Author contributions: Ms Edvardsen is guarantor of the study and takes responsibility for the accuracy of the data.

Ms Edvardsen: contributed by actively planning the study; controlling the equipment and quality of the test procedures; collecting, analyzing, and interpreting the data; and drafting the manuscript.

Dr Hansen: contributed to the conception and design of the study, coordinated the data collection, analyzed the data, and reviewed the manuscript critically.

Dr Holme: contributed to the

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    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

    Funding/Support: This work was supported by the Norwegian Directorate of Health.

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