Physical Activity Versus Cardiorespiratory Fitness: Two (Partly) Distinct Components of Cardiovascular Health?

DeFina, Laura F.; Haskell, William L.; Willis, Benjamin L.; Barlow, Carolyn E.; Finley, Carrie E.; Levine, Benjamin D.; Cooper, Kenneth H.

doi:10.1016/j.pcad.2014.09.008

Cited by 231 publications

(173 citation statements)

References 59 publications

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“…[1][2][3][4] Being physically active ( PA; i.e., moving more throughout the day), consuming a nutritious diet, not smoking and maintaining an appropriate body weight combine to constitute the HL polypill, serving as the foundation of HL medicine (HLM). 2,5,6 The benefits of daily use of the HL polypill, working toward optimal dosages, portends profound health benefits, substantially reducing the risk of chronic disease [i.e., cardiovascular disease (CVD), pulmonary disease, metabolic syndromes, certain cancers, etc.]…”

Section: Introductionmentioning

confidence: 99%

Public Park Spaces as a Platform to Promote Healthy Living: Introducing a HealthPark Concept

Arena

Bond

O’Neill³

et al. 2017

Progress in Cardiovascular Diseases

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The concept of Healthy Living (HL) as a primary medical intervention continues to gain traction, and rightfully so. Being physically active, consuming a nutritious diet, not smoking and maintaining an appropriate body weight constitute the HL polypill, the foundation of HL medicine (HLM). Daily use of the HL polypill, working toward optimal dosages, portends profound health benefits, substantially reducing the risk of chronic disease [i.e., cardiovascular disease (CVD), pulmonary disease, metabolic syndromes, certain cancers, etc.] and associated adverse health consequences. To be effective and proactive, our healthcare system must rethink where its primary intervention, HLM, is delivered. Waiting for individuals to come to the traditional outpatient setting is an ineffective approach as poor lifestyle habits are typically well established by the time care is initiated. Ideally, HLM should be delivered where individuals live, work and go to school, promoting immersion in a culture of health and wellness. To this end, there is a growing interest in the use of public parks as a platform to promote the adoption of HL behaviors. The current perspectives paper provides a brief literature review on the use of public parks for HL interventions and introduces a new HealthPark model being developed in Chicago.

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Section: Introductionmentioning

confidence: 99%

Public Park Spaces as a Platform to Promote Healthy Living: Introducing a HealthPark Concept

Arena

Bond

O’Neill³

et al. 2017

Progress in Cardiovascular Diseases

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“…The variability is postulated to be based on reimbursement policies. Clearly, evidence is needed to demarcate minimum dose of CR needed to significantly improve patient quality and quantity of life, with consideration of case-mix 95 , so quality of care in countries/regions not meeting this minimum can be improved.With regard to core components delivered, exercise training was the most consistently offered one overall, but also in the regions of Europe and Latin America; this is laudable given that the greatest improvements in prognosis are explained by improvements in cardiorespiratory fitness achieved through physical activity [96][97][98][99] . Clearly great efforts are needed to increase CR penetration in healthcare systems across the globe, given these are highly cost-effective strategies [100][101][102][103] .…”

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confidence: 99%

A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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Herein, 28 publications describing cardiac rehabilitation (CR) delivery in 50 of the 113 countries globally suspected to deliver it are reviewed, to characterize the nature of services. Government funding was the main source of CR reimbursement in most countries (73%), with private and patient funding in about ¼ of cases.Myocardial infarction patients and those having revascularization were commonly served. The main professions delivering CR were physicians, nurses, and physiotherapists. Programs offered a median of 20 sessions, although this varied. Most programs offered the core components of exercise training, patient education and nutrition counselling. Alternative models were not commonly offered. Lack of human and/or financial resources as well as space constraints were reported as the major barriers to delivery. Overall, CR delivery has been characterized in less than half of the countries where it is offered. The nature of services delivered is fairly consistent with major CR guidelines and statements.Keywords: cardiac rehabilitation, global health, secondary prevention Alphabetical List of Abbreviations: AS= administrative support CABG = coronary artery bypass graft CB = community-based A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT2 CR = cardiac rehabilitation CPR= cardiopulmonary resuscitation CVD = cardiovascular disease ECG = electrocardiogram EQ= equipment ET = exercise training FR= financial resources HB = home-based HF = heart failure HR= human resources IA = initial assessment IB = internet-based IHD = ischemic heart disease LMIC = low-and middle-income country MI = myocardial infarction NC = nutrition counseling NZ = New Zealand PAW= patient awareness PCI = percutaneous coronary intervention PE = patient education PR= patient referral RF = risk factor management SC = smoking cessation SM = stress management and/or psychosocial support/counselling TI = transportation issues UAE = United Arab Emirates VAD = ventricular assist device A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 By 2030, it is expected 84 million individuals will be diagnosed with cardiovascular disease (CVD) 1 .Moreover, it is among the leading causes of disability around the world, and contributes to 10% of disabilityadjusted life years lost world-wide 2 . With improved survival (in high-income countries 3 ), clearly there is a great need for secondary prevention, such as is offered in cardiac rehabilitation (CR) programs.Many meta-analyses demonstrate that participation in CR is associated with improved quality of life, as well as decreased morbidity and mortality [4][5][6][7] . CR is also cost-effective 8 . Accordingly, it is a class 1 level A recommendation in clinical practice guidelines for CVD patients 9,10 . 19 , have established guidelines to ensure consistent provision and quality of CR delivery in order to achieve the greatest population health benefits. They all outline the nature of patients indicated for services, and make recommendations regarding the composition of a multi-disciplinary...

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“…1,6 My colleagues and I have published extensively, not only on the benefits of PA, but especially on the benefits of having high levels of cardiorespiratory fitness (CRF), 1,6 even suggesting that CRF should become a vital sign for clinical practices. 7 Although PA is extremely important, substantial data suggest that CRF predicts prognosis even more so than does PA. 8,9 However, although a component of CRF may be genetic or inherited, the major part of CRF is derived from persistent and effective PA and exercise training. 6 In fact, each metabolic equivalent (MET) increase in CRF is associated with 13% and 15% reductions in all-cause mortality and in CVD/CHD events, respectively, in a major meta-analysis.…”

mentioning

confidence: 99%