Physical activity in the prevention of atherosclerotic coronary heart disease
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There are compelling epidemiologic and clinical data demonstrating that regular physical activity reduces the incidence of atherosclerotic vascular disease. The hypothesis that exercise decreases atherosclerotic coronary heart disease has never been directly tested in a randomized, controlled clinical trial. Nevertheless, there are sufficient data to recommend that adults should routinely engage in moderately vigorous physical activity. Exercise training also improves multiple atherosclerotic cardiovascular risk factors, including low levels of high-density lipoprotein cholesterol, blood triglycerides, blood pressure, glucose intolerance, insulin resistance, and obesity. Some of this effect attributed to exercise training is actually an acute effect of recent exercise and not a chronic metabolic adaptation. There are multiple randomized controlled clinical trials of exercise training in patients with established coronary artery disease enrolled in cardiac rehabilitation programs. These results demonstrate that exercise training reduces total cardiovascular mortality in patients with established coronary heart disease. The evidence cited above supports the recommendation that all stable adults should participate daily in a minimum of 30 minutes of moderately vigorous physical activity. Less activity than this is probably beneficial, whereas more activity is probably more beneficial.
- Paffenbarger RS Jr, Blair SN, Lee IM: A history of physical activity, cardiovascular health and longevity: the scientific contributions of Jeremy N Morris, DSc, DPH, FRCP. Int J Epidemiol 2001, 30:1184–1192. CrossRef
- Lee IM, Paffenbarger RS Jr, Hennekens CH: Physical activity, physical fitness and longevity. Aging (Milano) 1997, 9:2–11.
- Morris J, Heady J, Raffle P, Roberts C: Coronary heart disease and physical activity of work. Lancet 1953, 2:1053–1057. CrossRef
- Paffenbarger RS Jr, Wing AL, Hyde RT: Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol 1978, 108:161–175.
- Manson JE, Greenland P, LaCroix AZ, et al.: Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 2002, 347:716–725. This is the largest study on exercise and the risk of heart disease in women. Also, contains sufficient women to examine the contribution of vigorous exertion and the risk in blacks. CrossRef
- Powell KE, Thompson PD, Caspersen CJ, Kendrick JS: Physical activity and the incidence of coronary heart disease. Annu Rev Public Health 1987, 8:253–287. CrossRef
- Sesso HD, Paffenbarger RS Jr, Lee IM: Physical activity and coronary heart disease in men: the Harvard Alumni Health Study. Circulation 2000, 102:975–980. This continues the examination of physical activity and CHD risk in middle-aged men and demonstrates a possible threshold effect.
- Lee IM, Paffenbarger RS Jr: The role of physical activity in the prevention of coronary artery disease. In Exercise and Sports Cardiology. Edited by Thompson PD. New York, NY: McGraw-Hill; 2001:383–401.
- Blair SN, Jackson AS: Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc 2001, 33:762–764. CrossRef
- Pate RR, Pratt M, Blair SN, et al.: Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995, 273:402–407. CrossRef
- Williams PT: Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc 2001, 33:754–761.
- Thompson PD, Cullinane EM, Sady SP, et al.: High density lipoprotein metabolism in endurance athletes and sedentary men. Circulation 1991, 84:140–152.
- Leon AS, Sanchez OA: Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001, 33(6 suppl):S502-S515. A comprehensive evaluation of the literature on the lipid response to exercise training.
- Thompson PD, Rader DJ: Does exercise increase HDL cholesterol in those who need it the most? Arterioscler Thromb Vasc Biol 2001, 21:1097–1098.
- Fagard RH: Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc 2001, 33(6 suppl):S484-S492. A comprehensive evaluation of the literature on blood pressure response to exercise training.
- Thompson PD, Crouse SF, Goodpaster B, et al.: The acute versus the chronic response to exercise. Med Sci Sports Exerc 2001, 33(6 suppl):S438-S445.
- Knowler WC, Barrett-Connor E, Fowler SE, et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393–403. CrossRef
- Wing RR, Hill JO: Successful weight loss maintenance. Annu Rev Nutr 2001, 21:323–341. CrossRef
- Ussher MH, West R, Taylor AH, McEwen A: Exercise interventions for smoking cessation. Cochrane Database Syst Rev 2000, (3):CD002295.
- Marcus BH, Albrecht AE, King TK, et al.: The efficacy of exercise as an aid for smoking cessation in women: a randomized controlled trial. Arch Intern Med 1999, 159:1229–1234. CrossRef
- Billman GE, Schwartz PJ, Stone HL: The effects of daily exercise on susceptibility to sudden cardiac death. Circulation 1984, 69:1182–1189.
- Hambrecht R, Wolf A, Gielen S, et al.: Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med 2000, 342:454–460. CrossRef
- Li N, Wallen NH, Hjemdahl P: Evidence for prothrombotic effects of exercise and limited protection by aspirin. Circulation 1999, 100:1374–1379.
- Jolliffe JA, Rees K, Taylor RS, et al.: Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2001, (1):CD001800. The most up-to-date review on outcomes after exercise-based cardiac rehabilitation.
- Thompson PD: The cardiovascular risks of exercise. In Exercise and Sports Cardiology. Edited by Thompson PD. New York, NY: McGraw-Hill; 2001:127–145.
- Physical activity in the prevention of atherosclerotic coronary heart disease
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