Low VO2 Max notification on Apple Watch may point to an early heart health warning in some cases

Low VO2 Max on fitness trackers

Apple Watches help users monitor their cardio fitness level and send a notification when VO2 Max is low.

Although many users see the low V02 max notification from time to time, it may be beneficial to speak to your cardiologist if you repeatedly get these notifications from your Apple Watch.

Researchers at Shackler School of Medicine, Tel-Aviv, and Leviev Heart Center, Israel, recently provided an interesting case when checking the peak oxygen consumption of a user with consistently low VO2 max readings on his Apple Watch.

Related reading:

Low VO2 max on Apple Watch was investigated and showed severely reduced left ventricular systolic function

In this case, the person is a healthy 40-year-old male who was getting the low VO2 max notification on his Apple Watch.

Researchers ran several tests revealing a diagnosis of familial nonischemic cardiomyopathy with severely reduced left ventricular systolic function.

The report was originally published in the Interactive Journal of Medical Research this week.

Familial dilated cardiomyopathy occurs when heart muscles become thin and weakened in at least one chamber of the heart, causing the chamber’s open area to enlarge (dilated). 

As a result, the heart cannot pump blood as efficiently as usual. To compensate, the heart attempts to increase the amount of blood pumped through the heart, leading to further thinning and weakening of the cardiac muscle. Over time, this condition results in heart failure.

It usually takes many years for symptoms of familial dilated cardiomyopathy to cause health problems. They typically begin in mid-adulthood but can occur at any time from infancy to late adulthood.

The case was identified at Sheba Medical Center, Israel, and the patient’s cardiac fitness was monitored through an Apple Watch Series 6. The patient underwent a comprehensive cardiac workup following his presentation.  

This case report highlights the potential utility of peak VO2 measurements by wearable devices for early identification and screening of cardiac fitness for the general population and those at increased risk of cardiovascular disease.

The researchers suggest that successfully integrating wearable devices into routine patient evaluation may allow for earlier presentation in the diagnostic workflow but caution that more studies are required to obtain appropriate FDA approvals.

A Word of caution 

The case described above could be a one-off case. Many Apple Watch users see this notification from time to time.

Most people can improve their VO2 max by increasing the intensity and frequency of their cardiovascular exercise. It is also worthwhile noting that certain conditions or medications that limit your heart rate might cause an overestimation of your VO2 max.

Here are some VO2 max ranges by age and sex that you can use to compare.Mens VO2 Max levels by age

VO2 Max acceptable levels for women

We suggest users make sure that their Apple Watch is calibrated properly to reduce any negative notifications.

Apple recommends checking the Health app to ensure you get the correct VO2 max scores. We also suggest checking out the following articles highlighting some of the issues surrounding low VO2 max and what you can do.

According to Apple’s support document, If the Health app detects that your previous cardio fitness estimates could be more accurate, you can update your data and get a better cardio fitness score.

In Cardio Fitness, tap Update under Update Your Data. After you update, the Cardio Fitness Data Updated notification shows you the updated results and how your estimates changed.

Apple Watch has been a lifesaver in numerous stories ranging from users receiving help following a hard fall to obtaining emergency help after a vehicle crash.

The heart health data from Apple Watch has also saved many people’s lives, especially for folks with Afib complications.

Apple is currently running numerous clinical studies using the motion and heart sensor data to identify new use case scenarios that can be presented to FDA in the future. Stay tuned!

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Sudz Niel Kar
I am a technologist with years of experience with Apple and wearOS products, have a BS in Computer Science and an MBA specializing in emerging tech, and owned the popular site AppleToolBox. In my day job, I advise Fortune 500 companies with their digital transformation strategies and also consult with numerous digital health startups in an advisory capacity. I'm VERY interested in exploring the digital health and fitness-tech evolution and keeping a close eye on patents, FDA approvals, strategic partnerships, and developments happening in the wearables and digital health sector. When I'm not writing or presenting, I run with my Apple Watch Ultra or Samsung Galaxy Watch and closely monitor my HRV and other recovery metrics.

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