AHA: Assess Fitness as a New Vital Sign

November 30, 2016

By Greg Vachon, MD, MPH

Great news! The American Heart Association (AHA) has called upon doctors to assess fitness as a vital sign, right alongside weight and blood pressure. Kaiser Permanente has done the same in their Exercise as a Vital Sign (ESV) program. Momentum is building for fitness to be routinely assessed … and rightly so. Low fitness causes death, disability and has a huge impact on employers.

Doctors in the US have been called to action before on various public health menaces over the decades. Blood pressure treatment started in earnest in the 1950s with the discovery of effective medication. Public health campaigns and physician practice changes in the 70’s led to better blood pressure treatment and a 75% fall in strokes between 1970 and this decade. Smoking was definitively brought onto the naughty list in 1964, with doctors expressly being asked by the Surgeon General to join a push against smoking. Smoking rates have declined from 42% to 17% and lung cancer rates have been decreasing every year by 1 to 2% over the last two decades. Cholesterol treatment with statins gained steam in the 1990s and they have been shown to reduce heart attacks by over 25%, contributing to the nearly 75% decline in deaths from heart attacks since 1980. Obesity has been recognized as a public health crisis and has moved (slowly) from being viewed as a personal failure to a medical issue to be addressed. The shift occurred most strongly in the first decade of this century and the rise in obesity appears to be slowing, with childhood obesity actually on the decline. Yet one of the strongest drivers of death and disability has received scant medical attention: fitness. Its time has come!

Research has shown that poor fitness is very costly, contributing as much as smoking and high blood pressure to bad outcomes, like cancers and heart attacks. Doctors ought to focus on fitness with the same attention given to the other scourges that have been and continue to be addressed. As reported in the NYT this past week, the AHA has sent out a strong call to action that fitness ought to be a vital sign, right there beside weight, height and blood pressure.  A new era is opening! PUSH for Wellness has had a strong focus on fitness from our founding, helping thousands to move the needle on their fitness with real, objective increases in their cardiovascular score. We get it. And we’re ready!

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