There is no one single best predictor of cardiovascular health. Besides cardiovascular health is more related to the heart as opposed to the lungs, although obviously the heart and lungs go hand in hand. VO2 might be a good predictor of lung function, and peak VO2 would go up if your general fitness goes up, but if one has just a so-so vo2, that doesn't mean other biomarkers will be horrible including more 'heart/vascular' things like CRP, LDL, etc. In that sense, one could have excellent cardiovascular health without doing any cardio other than weight training. Cardio might not even be necessary in terms of heart health. For most though, it can't hurt! Vo2 has been looked at to predict severe cardiovascular events. But generally we're talking about in people with heart failure, etc. Looking at healthy fit population, I think you'd be looking at a host of markers.
Diet can go a long way in improving all typical markers, and if you know what your doing, diet can pretty much control all those results for many people. Exercise can speed the process. But just like building muscle, it is near impossible to out-exercise a bad diet. Outside that, exercise has so many other benefits that can't be measured in a lab. Especially if you enjoy it. The key isn't to avoid it (if you want to do it) in order to gain another pound of muscle over 5 years.
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