Physical Activity, Cardiorespiratory Fitness, and Exercise Training in Primary and Secondary Coronary Prevention

Swift, Damon L.; Lavie, Carl J.; Johannsen, Neil M.; Arena, Ross; Earnest, Conrad P.; O’Keefe, James H.; Milani, Richard V.; Blair, Steven N.; Church, Timothy S.

doi:10.1253/circj.cj-13-0007

Cited by 281 publications

(243 citation statements)

References 163 publications

(97 reference statements)

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“…CR is a comprehensive therapy and can improve physical activity and psychological function, quality of life, and the prognosis in patients with CVD. [1][2][3][4][5][6][7] The prognostic value of blood pressure (BP) is based mainly on measurements obtained in a clinical setting. 7) High BP is a major risk factor for the onset and progression of CVD, 8) and exercise training has been shown to reduce BP in patients with hypertension (HTN).…”

Section: Ardiac Rehabilitation (Cr) Is Designed To Help Patientsmentioning

confidence: 99%

Visit-to-Visit Variability and Reduction in Blood Pressure After a 3-Month Cardiac Rehabilitation Program in Patients With Cardiovascular Disease

et al. 2016

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SummaryVisit-to-visit variability (VVV) in blood pressure (BP) has been shown to be a predictor of cardiovascular events. It is unknown whether CR can improve VVV in BP as well as reducing BP. We enrolled 84 patients who had cardiovascular disease (CVD) and participated in a 3-month CR program. We measured systolic and diastolic BP (SBP and DBP), pulse pressure (PP), and heart rate (HR) before exercise training at each visit and determined VVV in BP or HR expressed as the standard deviation of the average BP or HR. Patients who had uncontrolled BP at baseline and who did not change their antihypertensive drugs throughout the study period showed a significant reduction of both SBP and DBP with a decrease in PP after 3 months. Patients who did not change their antihypertensive drugs were divided into larger (L-) and smaller (S-) VVV in the SBP groups and L-and S-VVV in the DBP groups according to the average value of VVV in SBP or DBP. In the L-VVV in the SBP and DBP groups, VVV in SBP and DBP in the 1st month was significantly decreased after the 3rd month in both groups. HR at baseline was significantly decreased after 3 months. In addition, CR induced a significant increase in the level of high-density lipoprotein cholesterol (HDL-C) in blood. In conclusion, CR improved VVV in BP in patients with L-VVV in BP and evoked a significant reduction in HR and an increase in HDL-C. These effects due to the CR program may be cardioprotective. (Int Heart J 2016; 57: 607-614) Key words: Cardioprotection, Heart rate, High-density lipoprotein cholesterol C ardiac rehabilitation (CR) is designed to help patients recovering from a heart attack, other various cardiovascular diseases, (CVD) or cardiac surgery. CR is a comprehensive therapy and can improve physical activity and psychological function, quality of life, and the prognosis in patients with CVD. 1-7)The prognostic value of blood pressure (BP) is based mainly on measurements obtained in a clinical setting. 7) High BP is a major risk factor for the onset and progression of CVD,8) and exercise training has been shown to reduce BP in patients with hypertension (HTN).9,10) A recent report indicated that visit-to-visit variability (VVV) in BP is reproducible and not a random phenomenon.11) The Anglo-Scandinavian Cardiac Outcomes Trial Blood Pressure Lowering Arm reported that VVV in systolic BP (SBP) and maximum SBP were significantly associated with future risks of stroke and other CVD events independent of mean BP and other cardiovascular risk factors.12) Moreover, others have also indicated that VVV in BP is a predictor of the development of atherosclerotic diseases including stroke and myocardial infarction, and cardiovascular and all-cause mortality.12-15) Nonetheless, there is no recommendation on how to manage patients with CVD regarding the optimal control of VVV in BP.

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Section: Ardiac Rehabilitation (Cr) Is Designed To Help Patientsmentioning

confidence: 99%

Visit-to-Visit Variability and Reduction in Blood Pressure After a 3-Month Cardiac Rehabilitation Program in Patients With Cardiovascular Disease

et al. 2016

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“…A study was conducted to examine the effect of a twelve-week aerobic dynamic physical exercise on heart muscle remodeling in patients after corrective TOF surgery, which demonstrated that there were no harmful effects of physical training on cardiac remodeling (14). According to the results of this study, repeated physical training reduces long-term risk for coronary disease, improves physical fitness and quality of life (16). In our patient, there were no limitations in the implementation of rehabilitation program, since there was no heart failure nor life-threatening arrhythmia: a full-scale physical training program was done and was well tolerated by the patient.…”

Section: Discussionmentioning

confidence: 94%

Rehabilitation of a Female Patient after Corrective Surgery for Tetralogy of Fallot

Cvetković¹,

Dordević²,

Sljivic³

et al. 2015

Acta Facultatis Medicae Naissensis

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Herein we present a 25-year-old female patient with tetralogy of Fallot (TOF). This congenital heart defect is not very common, but it is the most common one among cyanotic heart defects. Treatment of the patients with TF is surgical, with palliative or curative (corrective) intent. Our patient underwent palliative surgery, definitive correction, and another surgery for pulmonary valve insufficiency. During cardiovascular rehabilitation, the patient was rhythmically stable, with excellent tolerance of physical exertion. Bearing in mind that this was a young female person who previously had had two spontaneous abortions, pregnancy was not absolutely contraindicated, although spontaneous abortion and pregnancy complications were more common in these patients.

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“…Also, diagnosis of diabetes during the follow-up period could have caused underestimation of the associations between diabetes and myocardial infarction. We did not have data on cardiorespiratory fitness, which has been suggested as a more important predictor for cardiovascular outcome than either physical activity [31] or obesity [32]. Nevertheless, regularly performed physical activity has been shown to improve physical fitness in people with type 2 diabetes [33], suggesting that self-reported physical activity, at least to some degree, may reflect the participants' physical fitness.…”

Section: Discussionmentioning

confidence: 99%

The adverse association of diabetes with risk of first acute myocardial infarction is modified by physical activity and body mass index: prospective data from the HUNT Study, Norway

et al. 2014

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Aims/hypothesis Diabetes increases the risk of acute myocardial infarction (AMI) and effective means for primary prevention are warranted. We prospectively examined the joint association of diabetes and leisure-time physical activity, as well as of diabetes and BMI, with the risk of AMI. Methods A total of 55,534 men and women in the Norwegian HUNT Study were followed-up for first AMI by hospital admission registries and the Cause of Death Registry. Cox proportional adjusted HRs with 95% CIs were estimated. Results Overall, 1,887 incident AMIs occurred during 12.3 years. Compared with inactive people without diabetes, inactive people with diabetes had an HR of 2.37 (95% CI 1.58, 3.57), whereas the HR among highly active persons with diabetes was 1.04 (95% CI 0.62, 1.74). Normal-weight (BMI 18.5-25 kg/m 2 ) persons with diabetes had an HR of 1.60 (95% CI 1.05, 2.44) and obese (BMI>30 kg/m 2 ) persons with diabetes had an HR of 2.55 (95% CI 1.97, 3.29) compared with normal-weight persons without diabetes. The data suggest biological interaction between diabetes and physical activity, with a relative excess risk of inactivity and diabetes of 1.43 (95% CI 0.08, 2.78). For obesity and diabetes, the excess risk due to interaction was smaller (0.67; 95% CI −0.24, 1.58). Conclusions/interpretation Body weight and, in particular, physical activity modified the association between diabetes and risk of first AMI. This highlights the potential importance of physical activity and weight maintenance in primary prevention of AMI among people with diabetes.

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Physical Activity, Cardiorespiratory Fitness, and Exercise Training in Primary and Secondary Coronary Prevention

Cited by 281 publications

References 163 publications

Visit-to-Visit Variability and Reduction in Blood Pressure After a 3-Month Cardiac Rehabilitation Program in Patients With Cardiovascular Disease

Visit-to-Visit Variability and Reduction in Blood Pressure After a 3-Month Cardiac Rehabilitation Program in Patients With Cardiovascular Disease

Rehabilitation of a Female Patient after Corrective Surgery for Tetralogy of Fallot

The adverse association of diabetes with risk of first acute myocardial infarction is modified by physical activity and body mass index: prospective data from the HUNT Study, Norway

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