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.
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References and Recommended Reading
- 2.Lee IM, Paffenbarger RS Jr, Hennekens CH: Physical activity, physical fitness and longevity. Aging (Milano) 1997, 9:2–11.Google Scholar
- 5.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.PubMedCrossRefGoogle Scholar
- 7.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.PubMedGoogle Scholar
- 8.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.Google Scholar
- 19.Ussher MH, West R, Taylor AH, McEwen A: Exercise interventions for smoking cessation. Cochrane Database Syst Rev 2000, (3):CD002295.Google Scholar
- 24.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.Google Scholar
- 25.Thompson PD: The cardiovascular risks of exercise. In Exercise and Sports Cardiology. Edited by Thompson PD. New York, NY: McGraw-Hill; 2001:127–145.Google Scholar