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Physical Activity Strategies

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ASPC Manual of Preventive Cardiology

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Numerous studies now suggest that cardiorespiratory fitness (CRF), expressed as metabolic equivalents (METs), is one of the strongest prognostic markers in persons with and without coronary heart disease (CHD), regardless of the level of coronary artery calcium or the coronary risk factor profile. Each 1-MET increase in CRF confers an ~15% decrease in mortality up to about 10 METs. In addition, physically active and/or fit people are more likely to have lower annual healthcare costs and rates of chronic disease, including incident heart failure. Accordingly, sedentary individuals should be counseled to become more physically active and/or fit by starting an endurance exercise program, increasing lifestyle activity, or both. When individuals can adopt this regimen comfortably, that is, moderate-intensity exercise, they should strive for the goal of more vigorous exercise over time, provided they remain asymptomatic. On the other hand, unaccustomed vigorous- to high-intensity physical activity (PA), especially in previously inactive/unfit individuals with known or occult CHD, can trigger acute cardiac events. Moreover, extreme endurance exercise training regimens are associated with potential cardiac maladaptations in some individuals, including accelerated coronary calcification and an increased likelihood to develop atrial fibrillation. This relationship has been increasingly described by a U- or reverse J-shaped dose-response curve. Despite these recent findings, the benefits of moderate-to-vigorous PA far outweigh the risks for the majority of the population.

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Authors and Affiliations

  1. Department of Cardiology (Cardiac Rehabilitation), Beaumont Health & Wellness Center, Royal Oak, MI, USA

    Barry A. Franklin

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Editors and Affiliations

  1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA

    Nathan D. Wong

  2. Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA, USA

    Ezra A. Amsterdam

  3. Cicarrone Center for the Prevention of Cardiovascular Disease, John Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Franklin, B.A. (2021). Physical Activity Strategies. In: Wong, N.D., Amsterdam, E.A., Toth, P.P. (eds) ASPC Manual of Preventive Cardiology. Contemporary Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-56279-3_6

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