Fardman A, Banschick GD, Rabia R, et al. - Given that although cardiorespiratory fitness (CRF) represents a strong independent predictor of adverse cardiovascular outcomes, but current guidelines do not considered it as a risk enhancer, so, to gain clarity on this topic, researchers undertook this inquiry among asymptomatic self-referred adults (aged 40-79 years) who were free of cardiovascular disease at baseline. The participants underwent annual screening and completed baseline exercise stress test. They defined two groups for baseline CRF: low (metabolic equivalents < 8) and high. The primary endpoint included the composite of death, non-fatal acute coronary syndrome and stroke, following the removal of people diagnosed with metastatic cancer during follow up. A median follow up of 8 years revealed the occurrence of the study endpoint in 1,362 (9%) people. A significant 23% higher risk to develop the study endpoint was consistently observed in relation to lower fitness, in Cox regression model with adjustment for ASCVD risk. Overall, low CRF was identified as a strong independent predictor of the cardiovascular morbidity as well as mortality among asymptomatic adults. The incorporation of fitness into the pooled cohort ASCVD risk afforded significantly improved accuracy of the model.