Cardiovascular disease among top three causes of death - why you need to know your VO2 max metric

Vitality CFR Infographic.

By Neesa Moodley

3 Jul 2024

Cardiovascular or heart-related diseases have raced to the top three causes of death in the past two decades. And life assurers are starting to address the underlying causes.

Dr Marion Morkel, chief medical officer at Sanlam, says the increase in cardiovascular-related deaths is linked to lifestyle diseases and was magnified by the added mortality burden of the pandemic.

“We continue to fail to address the key causes of diseases of lifestyle, so, sadly, we’re likely to see cardiovascular incidents exponentially increase in the future. Obesity remains a major challenge in our country, with Type 2 diabetes linked to this.”

The Heart and Stroke Foundation of South Africa says one in three males will have a cardiac event before they die; for women, this statistic is one in four. Younger women have marginal protection due to their hormones, which decreases when menopause is reached.

Dr Nadia Goolam Amod, senior medical officer at PPS Life Solutions, says cardiovascular disease encompasses conditions such as heart attacks, strokes and heart failure. Notably, ischaemic heart disease, also known as coronary heart disease, refers to heart issues resulting from narrowed coronary arteries that supply blood to the heart muscle.

“This condition stands out as a significant threat to women’s health. Alarmingly, women with ischaemic heart disease face a heightened risk of mortality from acute heart attacks compared with men of a similar age,” she says.

Over the past year, five of the big life assurers have seen cardiovascular disease in the top three causes of death claims:

Sanlam: Cardiovascular disease accounted for 22% of all death and funeral claims. It also accounted for 19% of disability claims for men.

Liberty: Cardiovascular disorders made up 23.4% of all lifestyle protection claims. It was the second highest claim condition – beaten only by cancer and ahead of respiratory disorders, strokes and traumatic injuries. It was responsible for 26% of claims for men and 18% for women.

Momentum Life Insurance: Cancer and cardiovascular conditions topped the mortality claims, accounting for 57% of deaths, with significant gender differences observed. Cardiovascular conditions and cancer were responsible for more than half of death claims (57%) in 2023 and were the top two causes of death for both sexes.

Old Mutual: In 2022, cardiovascular conditions were the second highest reason for claims among men and the top claim category for women. Old Mutual has not yet released its claims stats for 2023.

Vitality CFR.

What you can do about it

A new white paper released by Discovery Vitality emphasises the need to view cardiorespiratory fitness (measured as VO2 max) as an important health risk metric.

Cardiorespiratory fitness refers to how well your respiratory and circulatory systems supply your body with enough oxygen to keep exercising. VO2 max is a measure of the maximum amount of oxygen that your body can use when you’re exercising.

As your VO2 max increases, so does your aerobic endurance and ultimately your cardiorespiratory fitness. Cardiorespiratory fitness is a powerful indicator of one’s potential for a long and healthy life, as even a moderate improvement in VO2 max can reduce the risk of death by 21%-30%.

“My vision is that the insights from this research on cardiorespiratory fitness help inform the global effort to combat the growing epidemic of physical inactivity and its associated health risks,” says Vitality chief executive officer Dinesh Govender.

“We’re continually exploring ways to incentivise and promote healthier lifestyles among our members, and it’s important that these are backed by research and enabled through the smart use of technology to fit easily into people’s lives.”

Vitality’s white paper on navigating cardio fitness for optimal health outcomes shows that Vitality members with higher cardiorespiratory fitness levels experience 30% lower hospital claims, and exhibit a 95% lower prevalence of obesity, an 84% lower prevalence of high-risk blood glucose levels, and a 70% lower prevalence of high blood pressure.

Those with higher cardio fitness levels also tend to have earlier bedtimes, earlier wake-up times, and longer sleep durations.

“Through [the use of] wearable technology … our members can easily estimate their VO2 max. This cardio fitness measurement serves as a valuable benchmark for overall health,” says Dr Mosima Mabunda, Vitality’s head of wellness.

Read more in Daily Maverick: Wearables and AI are accelerating a global move towards better healthcare

Aerobic exercise for the win

Jon Patricios, Professor of Sports and Exercise Medicine at Wits University, says the prescription of aerobic-based exercise provides some of the most effective disease prevention strategies and should be a core lifestyle intervention.

From July 2024 onwards, Vitality members will be incentivised to know and improve their VO2 max and can earn up to 10,000 Vitality points. VO2 max readings will be categorised into five cardio fitness levels: low, fair, good, excellent and superior.

“By rewarding Vitality members for knowing and improving their cardio fitness, we are not only encouraging varied exercise intensities and durations, but also helping them protect their health and extend their lifespans,” says Govender. DM

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What you can do about it

Aerobic exercise for the win