Exercise Benefits in Cardiovascular Diseases

From Mechanisms to Clinical Implementation

Pedro L. Valenzuela; Luis M. Ruilope; Alejandro Santos-Lozano; Matthias Wilhelm; Nicolle Kränkel; Carmen Fiuza-Luces; Alejandro Lucia

Disclosures

Eur Heart J. 2023;44(21):1874-1889.

Abstract and Introduction

Abstract

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Summary of the main effects of regular physical activity (PA) and exercise on cardiovascular disease (CVD). WHO, World Health Organization.

There is a pandemic of physical inactivity that appears to parallel the widespread prevalence of cardiovascular disease (CVD). Yet, regular physical activity (PA) and exercise can play an important role not only in primary cardiovascular prevention but also in secondary prevention. This review discusses some of the main cardiovascular effects of PA/exercise and the mechanisms involved, including a healthier metabolic milieu with attenuation of systemic chronic inflammation, as well as adaptations at the vascular (antiatherogenic effects) and heart tissue (myocardial regeneration and cardioprotection) levels. The current evidence for safe implementation of PA and exercise in patients with CVD is also summarized.

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Abstract and Introduction
Cardiovascular Disease Prevention: Epidemiological Evidence
Mechanisms
Conclusions
References

Table 1. Exercise prescription for adults, including those with cardiovascular disease
Component	Recommendation (per week)	Examples of prescription
'Aerobic' (endurance)	150–300 min of moderate-intensity PA, 75–150 min of vigorous-intensity PA, or a combination thereof	F: 5 times/weekI: 40%–69% of VO_2peak or HRR, or RPE scale 12–13 T: 30–60 min/session T: continuous jogging/brisk walking/cycling or F: 3 times/week I: 70%–85% of VO_2peak or HRR, or RPE scale 14–16 T: 25–50 min/session T: continuous running/fast cycling, intervals of higher intensities
Muscle strengthening ('resistance training')	Muscle-strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days	F: 2–3 times/week I: 50%–80% of 1-RM or 8–15 repetitions to failure T: 1–3 sets per muscle group T: 8–10 dynamic or static resistance exercises including all major muscle groups
Sedentarism	Limiting the amount of time spent being sedentary	- Replacing sedentary time with PA of any intensity (including light intensity) - Doing more than the recommended weekly levels of moderate-to-vigorous PA

Examples are provided following the FITT principle (i.e. frequency, intensity, time, and type), except for sedentarism.
1-RM, one-repetition maximum; HRR, heart rate reserve; PA, physical activity; RPE, rate of perceived exertion; VO_2peak, peak oxygen uptake.
Sources: 2020 World Health Organization guidelines on physical activity and sedentary behaviour,¹ 2020 European Society of Cardiology guidelines on sports cardiology and exercise in patients with cardiovascular disease,⁴⁸ and the 2022 position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology.⁵⁴

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Exercise Benefits in Cardiovascular Diseases

From Mechanisms to Clinical Implementation

Abstract and Introduction

Abstract

Tables

References

Authors and Disclosures

Authors and Disclosures

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