Protocol
VO2max / cardiopulmonary exercise testing
VO2 max · VO2max testing · CPET · cardiopulmonary exercise testing · cardiorespiratory fitness testing · maximal oxygen uptake · exercise treadmill testing with gas exchange
Cardiorespiratory fitness is among the most robustly evidenced predictors of all-cause mortality in humans. A retrospective cohort of 122,007 adults undergoing exercise treadmill testing at the Cleveland Clinic (JAMA Network Open, 2018, median follow-up 8.4 years) found an inverse, graded relationship between fitness and mortality, with elite performers at an adjusted hazard ratio of 0.20 versus low performers and no observed upper limit of benefit. The 2016 American Heart Association scientific statement concluded that low CRF is associated with high cardiovascular and all-cause mortality risk, is potentially a stronger predictor than smoking, hypertension, dyslipidaemia or type 2 diabetes, and significantly improves risk reclassification. What this does NOT show: the evidence establishes fitness as a modifiable exposure and a prognostic marker, not that the act of measuring VO2max changes outcomes. There is no trial demonstrating that VO2max testing itself extends lifespan or healthspan; the causal arm of the evidence rests on exercise training trials, and no RCT randomises people to being tested. Clinic-quoted effect sizes (for example Everlab's "for every 10-point increase in VO2 Max, there is a 17 per cent lower risk of death from cancer and an 11 percent reduction in overall mortality") are observational associations presented without a cited source and should not be read as causal. VO2max is also effort-dependent and protocol-dependent, so values are not directly comparable across providers, and estimated (submaximal or wearable-derived) VO2max is a weaker measure than a true maximal test with gas exchange.
At a glance
- Evidence
- Clinical
- Singapore (HSA)
- Not applicable as a product registration. HSA regulates the import, manufacture, export and supply of medical devices as products, and does not regulate clinical procedures or services performed by clinicians, so a VO2max test carries no HSA approval status of its own. The metabolic cart and gas analyser hardware used to perform it falls within HSA's medical device remit as equipment, while the test itself is delivered as routine clinical physiology, offered in Singapore by NOVI Health as a paid add-on (SGD 250 with GST) performed at a partner clinic.
- Australia (TGA)
- Not a TGA-registered therapeutic good, because CPET is a clinical procedure rather than a product. It is delivered in Australia as established clinical exercise physiology, including by longevity clinics such as Everlab, which requires medical clearance for clients over 35. Caveat: repeated attempts to reach tga.gov.au during this research timed out, so the TGA-side framing (that the TGA regulates therapeutic goods, not clinical procedures, and that specific metabolic cart analysers are separately included on the ARTG as medical devices) could not be confirmed against a live TGA source and should be re-verified before publication.
- Offered at
- 2 clinics
Singapore
Health Sciences Authority
- HSA status
- Not applicable as a product registration. HSA regulates the import, manufacture, export and supply of medical devices as products, and does not regulate clinical procedures or services performed by clinicians, so a VO2max test carries no HSA approval status of its own. The metabolic cart and gas analyser hardware used to perform it falls within HSA's medical device remit as equipment, while the test itself is delivered as routine clinical physiology, offered in Singapore by NOVI Health as a paid add-on (SGD 250 with GST) performed at a partner clinic.
- In our SG set
- Tracked in Singapore
- SG clinics
- 1
Australia
Therapeutic Goods Administration
- TGA status
- Not a TGA-registered therapeutic good, because CPET is a clinical procedure rather than a product. It is delivered in Australia as established clinical exercise physiology, including by longevity clinics such as Everlab, which requires medical clearance for clients over 35. Caveat: repeated attempts to reach tga.gov.au during this research timed out, so the TGA-side framing (that the TGA regulates therapeutic goods, not clinical procedures, and that specific metabolic cart analysers are separately included on the ARTG as medical devices) could not be confirmed against a live TGA source and should be re-verified before publication.
- In our AU set
- Tracked in Australia
- AU clinics
- 1
Evidence is not approvalAn evidence grade describes how strong the science is. A regulatory status describes whether a body has approved the intervention for an indication. They are different questions, answered separately above.
What it is
Plain-language explainer
VO2max is the maximum rate at which the body can take up and use oxygen during progressively harder exercise, measured directly by breath-by-breath gas analysis during an incremental treadmill or cycle test taken to exhaustion. It is the standard quantitative measure of cardiorespiratory fitness and is used in longevity practice as a prognostic marker and as a baseline for prescribing training. Clinics position it as a predictor of long-term mortality risk and a way to track whether an exercise programme is working.
Categories
Protocol
Keep reading
Related coverage from the newsroom.
Sources
What this profile is built on
- Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing · JAMA Network Open (via PubMed)
- Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign · Circulation, American Heart Association scientific statement (via PubMed)
- Medical Devices regulatory overview · Health Sciences Authority, Singapore
- NOVI Health assessments and add-on scans · NOVI Health
- Medical Tests (lists Body Fat % Test and Dexa Scan Test / bone density test) · Everlab (Australia)
- VO2 Max test - personalised training zones including Zone 2 heart rate and ventilatory thresholds · Everlab
- Longevity Medicine (DEXA body composition listed among physical markers in the VITAL Screen) · Advantage Medical Singapore
- VO2 Max testing and training guidance (Singapore) - explicit Zone 2 dose of 150-180 min/week plus 1-2 interval sessions · Advantage Medical Group
- VO2 Max test - personalised training zones including Zone 2 heart rate and ventilatory thresholds · Everlab
- Medical Devices regulatory overview · Health Sciences Authority, Singapore
Every entity profile on variis is sourced. Not medical advice.