Kokkinos P, et al. - In 20,254 US male veterans (mean age 58.0 ± 11.3 years), researchers studied the interactions between body mass index (BMI), cardiorespiratory fitness (CRF), and heart failure (HF). Between 1987 and 2017, participants had completed a maximal exercise treadmill test. Taking into account age-stratified quartiles of peak metabolic equivalents (METs) achieved, different categories of patients were defined: least-fit (4.5 ± 1.3), low-fit (6.7 ± 1.3), moderate-fit (8.1 ± 1.1), and high-fit (11.2 ± 2.4). Furthermore, normal weight (18.5–24.9 kg/m²), overweight (25–29.9 kg/m²), and obese (≥ 30.0 kg/m²) categories were defined based on BMI. Participants were followed-up for a median duration of 13.4 years. Irrespective of BMI, progressively lower HF risk was observed in relation to increased CRF. This implied that improved CRF could modulate elevated HF risk related to obesity.