Exercise Vital Signs: A New Way To Spot Hidden Health Risks

This article focuses on a simple screening tool called Exercise Vital Signs (EVS). It empowers individuals to track their activity levels and lower their risk of chronic diseases.

Contents hide

1 Introduction

2 Why Physical Inactivity Matters

3 What Is the Exercise Vital Sign (EVS)?

4 How the EVS Study Was Made

4.1 Who Was Screened:

4.2 What Was Measured:

4.3 Analysis:

5 Key Findings

5.1 People Who Were Screened Were a Little Healthier

5.1.1 Why The Difference Between the Screened and Unscreened?

5.2 Within the EVS Group, the “Active” Were the Healthiest

5.3 Why This Study Matters

5.4 Screening Works

5.5 Beyond Annual Wellness Visits

Introduction

Initially published to help healthcare providers identify patients at higher risk for chronic diseases due to a lack of exercise, the CDC published the study about EVS to inform healthcare providers that EVS can identify patients at higher risk for chronic diseases.

Although the study “Identifying Patients at Risk for Cardiometabolic and Chronic Diseases by Using the Exercise Vital Sign to Screen for Physical Inactivity,” published on January 2, 2025, was intended for Continuing Medical Education (CME) for physicians, I believe it also provides valuable insights for the general public interested in using the EVS on their own to prevent chronic diseases.

Why Physical Inactivity Matters

Physical inactivity—doing little or no moderate to vigorous exercise—has been linked to various health problems, such as:

Heart disease
Obesity
High blood pressure
Type 2 diabetes
Certain types of cancer
Early death

Despite knowing that regular exercise can prevent or improve these conditions, many doctor’s offices rarely measure or discuss physical activity with patients in a consistent way.

What Is the Exercise Vital Sign (EVS)?

The Exercise Vital Sign (EVS) is a quick, 2-question screening tool patients complete during their visit to a healthcare provider. It asks:

“On average, how many days per week do you engage in moderate to vigorous exercise (like a brisk walk)?” (0–7 days)
“On average, how many minutes do you exercise at this level?”

From these answers, healthcare providers calculate a person’s total minutes of exercise per week. Patients are then grouped into three categories based on weekly exercise:

Inactive: 0 minutes
Insufficiently Active: 1–149 minutes
Active: 150 minutes or more (aligned with many public health guidelines)

How the EVS Study Was Made

Who Was Screened:

Researchers looked at two groups of adult patients at a large Midwestern university hospital between 2017 and 2022:

- Those who completed the EVS (the “EVS cohort”)
- Those who did not complete the EVS (the “comparison cohort”)

What Was Measured:

- Demographic details (age, sex, race, ethnicity)
- Lab results (like cholesterol and blood sugar)
- Blood pressure, heart rate, height, weight, and Body Mass Index (BMI)
- Presence of any of 24 chronic health conditions (heart failure, diabetes, obesity, etc.)
- Smoking status

Analysis:

Researchers looked for differences in health profiles—such as blood pressure, obesity rates, and chronic disease—between:

- Screened (EVS) vs. Not Screened
- Inactive vs. Insufficiently Active vs. Active (within the EVS group)

Key Findings

People Who Were Screened Were a Little Healthier

The EVS group tended to have slightly lower blood pressure, lower resting pulse, lower average blood sugar (HbA1c), and a lower body mass index (BMI) than those not screened.
Although the differences were small overall, this group also had lower rates of certain chronic conditions:
- Obesity (15% vs 18%)
- Depression (17% vs 19%)
- hypertension (22% vs 28%)
- Uncomplicated diabetes (5.9% vs 8.5%)
- Complicated diabetes (4.4% vs 7.3%)
- Anemia deficiency (4.6% vs 6.1%)
- Hypothyroidism (9.3% vs 10.0%)
- Congestive heart failure (1.1% vs 1.9%)
- Moderate renal failure (1.8% vs 2.5%).

Why The Difference Between the Screened and Unscreened?

In this hospital setting, the EVS was usually given during annual wellness visits—appointments often attended by people already interested in preventing health issues or staying fit, which adds a risk of bias in the study.
People with more serious conditions may have skipped these optional screenings or visited specialty clinics that did not offer the EVS.

Within the EVS Group, the “Active” Were the Healthiest

Among patients who took the EVS:

60% were “Active” (150+ minutes/week)
36% were “Insufficiently Active” (1–149 minutes/week)
4% were “Inactive” (0 minutes/week)

Those who were “Active” generally had:

Better blood pressure
Better cholesterol (lower LDL and higher HDL)
Healthier weight (lower BMI)
Lower resting pulse
Fewer chronic conditions overall (fewer heart problems, less diabetes, etc.)

This confirms that people who report more exercise tend to have healthier profiles and fewer diseases linked to physical inactivity.

Why This Study Matters

Screening Works

The Exercise Vital Sign (EVS) is a simple tool to help doctors spot patients at higher risk from inactivity.

However, you don’t have to wait for your physician to do this for you. Many don’t have the time to ask and wait for you to recall.

To monitor your activity level, you can answer the same two EVS questions (number of exercise days per week and minutes per day) at home.

Recognizing your potential risk early can prevent or lower the risk of common chronic diseases.

Beyond Annual Wellness Visits

Ideally, everyone—not just those attending routine checkups—should keep track of their own EVS.

People living with conditions like obesity, high blood pressure, or diabetes may see the greatest benefits from self-monitoring and adjusting their exercise habits accordingly.

Small Steps Help

Some movement is better than none. Even a brief daily walk can be the first step toward achieving the recommended 150 minutes of moderate weekly exercise and improving overall health.

Tracking Evs Lowers Risk Of Chronic Diseases

Takeaways

Don’t Wait for Your Doctor
If your healthcare provider doesn’t automatically screen you for physical inactivity, you can do it yourself by answering two easy EVS questions:
- How many days per week do you engage in moderate-to-vigorous exercise?
- How many minutes do you exercise at that level?
Aim for 150 Minutes Weekly
Think 30 minutes a day, 5 days a week—this could be brisk walking, cycling, or another favorite activity.
Track Your Progress
Log your weekly exercise minutes using a notebook or a phone app. This simple habit can help you stay motivated and see your improvements over time.
You’re Not Alone
If you’re starting an exercise routine or have health concerns, talk with a healthcare provider or fitness professional about safe ways to increase your activity. Even small changes can lead to significant health benefits.

Conclusion

The Exercise Vital Sign (EVS) is a simple, evidence-based tool that healthcare providers and everyday people can use to identify risks associated with physical inactivity.

By tracking your minutes of moderate-to-vigorous exercise each week, you gain early awareness of potential health threats.

Small, consistent steps toward a 150-minute-per-week goal can significantly prevent or manage chronic conditions like hypertension, obesity, and diabetes.

Ultimately, combining self-monitoring with guidance from health professionals empowers you to adopt healthier habits, stay proactive about your well-being, and enjoy a better quality of life.

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Reference:

Chapman CG, Schroeder MC, Marcussen B, Carr LJ. Identifying Patients at Risk for Cardiometabolic and Chronic Diseases by Using the Exercise Vital Sign to Screen for Physical Inactivity. Prev Chronic Dis 2025;22:240149. DOI: http://dx.doi.org/10.5888/pcd22.240149