physical activity and cardiovascular disease pdf

Physical Activity And Cardiovascular Disease Pdf

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The authors summarize the pathophysiological changes associated with obesity, which lead to the development of CVD, recommendations for interventions such as diet, increased physical activity, and weight loss according to current literature and guidelines, and the critical importance of cardiorespiratory fitness CRF.

Physical Activity, Coronary Heart Disease, and Inflammatory Response

SEAN W. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality, whereas the Dietary Approaches to Stop Hypertension DASH eating plan is associated with a reduced risk of coronary artery disease.

Substituting dietary saturated fat with polyunsaturated fatty acids is associated with improved cardiovascular outcomes, although exogenous supplementation with omega-3 fatty acids does not improve cardiovascular outcomes. There is an association between increased sodium intake and cardiovascular risk, but reducing dietary sodium has not consistently shown a reduction in cardiovascular risk.

Physical activity recommendations for adults are at least minutes of moderate-intensity aerobic activity per week, 75 minutes of vigorous-intensity aerobic activity per week, or an equivalent combination. Increases in physical activity by any level are associated with reduced cardiovascular risk. Introducing muscle-strengthening activities at least twice per week in previously inactive adults is associated with improved cardiovascular outcomes.

Inactive adults without known CVD can gradually increase activity to a moderate-intensity level without consulting a physician. The U. Preventive Services Task Force recommends behavioral counseling to promote healthy diet and physical activity in adults at high risk of CVD. Evidence of benefit for counseling patients at average risk is less established. Nearly one-third of deaths from CVD are considered potentially preventable.

Recommendations for physical activity in adults are at least minutes of moderate-intensity aerobic activity or at least 75 minutes of vigorous-intensity aerobic activity per week.

Benefits of combined lifestyle interventions to reduce cardiovascular disease risk may be more pronounced in groups at higher risk, such as patients with diabetes mellitus or hypertension. Any physical activity is associated with lower cardiovascular risk, and the benefit increases with increasing amounts of weekly physical activity.

Although increased sodium intake has been associated with stroke and cardiovascular disease, a Cochrane review evaluating dietary sodium restriction in normotensive and hypertensive patients showed no effect on cardiovascular outcomes or all-cause mortality. Adults should follow an eating plan consistent with the Dietary Approaches to Stop Hypertension diet or the Mediterranean diet.

Substituting dietary saturated fat with polyunsaturated fat is recommended to reduce cardiovascular risk. Adults healthy enough to exercise should engage in at least minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent combination, each week. Physically inactive adults should be counseled that any increase in physical activity is associated with a reduction in cardiovascular risk.

Muscle-strengthening activity at least twice per week in previously inactive adults is associated with improved cardiovascular outcomes. Adults without a significant history of cardiovascular disease can gradually increase their activity level to moderate intensity safely without consulting a physician.

Information from reference 2. Adherence to these recommendations is low. It is difficult to isolate the effects of individual nutrients on health benefits. Current research suggests the greater importance of viewing diet as a whole rather than focusing on specific nutrients. Low-fat diets and high-fat, low-carbohydrate diets are popular and effective for weight loss, but there is insufficient evidence to recommend them for primary CVD prevention.

A summary of different dietary strategies is shown in Table 2. High intake of fruits and vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts; low intake of total and saturated fat and cholesterol Meta-analysis of cohort studies Fruits and vegetables; whole grains; olive oil; moderate intake of fish, seafood, dairy, wine Spanish randomized controlled trial Reduction in cardiovascular events over 4.

Low intake of saturated fat and sugar; higher intake of dietary fiber, fish, and fruits and vegetables 7. Swedish prospective cohort 7. Information from references 7 , and 10 through Mediterranean diets emphasize diversity and seasonality, fruits and vegetables, whole grains, and olive oil, with moderate intake of fish, seafood, dairy, and wine. A population-based prospective cohort study of 17, men in Sweden evaluated diet quality as measured by adherence to the Swedish dietary guidelines, emphasizing low intake of saturated fat and sugar, and higher intake of dietary fiber, fish, and fruits and vegetables.

The primary composite outcome after 16 years was cardiovascular events including MI, ischemic stroke, or death from ischemic heart disease. The DASH eating plan emphasizes a diet with high intake of fruits and vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts, and low intake of total and saturated fat and cholesterol.

There is significant debate about polyunsaturated fatty acids PUFAs and their role in the primary prevention of cardiovascular events. Several meta-analyses of RCTs have shown varying degrees of benefit for omega-3 fatty acids.

A meta-analysis of 21 prospective cohort studies involving more than , participants evaluated fish consumption and cerebrovascular disease over a mean of A meta-analysis of eight RCTs with more than 13, patients evaluated an increase in total or omega-6 PUFA intake as a substitute for saturated fat intake.

The primary outcome was a composite of cardiovascular events including MI, cardiovascular mortality, or sudden death. Observational data have linked increased sodium intake in overweight patients to an increased risk of stroke, CVD mortality, and all-cause mortality.

Based largely on observational data, the AHA published an updated recommendation in reaffirming that dietary sodium intake should not exceed 1, mg per day. Physical activity is routinely recommended to promote optimal cardiovascular health. Physical inactivity and a less active lifestyle have been linked to significant increases in CVD risk.

A study of 9, men and women 50 years and older used self-reports of physical activity to categorize participants into low, moderate, and high levels of activity. Objective parameters of exercise tolerance also show that increased exercise capacity is associated with lower mortality. Additionally, the age-adjusted RR of death incrementally increased with decreasing exercise capacity, both among otherwise healthy participants and those with CVD.

The Physical Activity Guidelines for Americans provide recommendations for physical activity Table 3. A systematic review of 33 studies evaluated different levels of physical activity on the risk of coronary heart disease. All adults should avoid inactivity. Adults who participate in any form of physical activity gain health benefits.

For substantial health benefits, adults should engage in at least minutes of moderate-intensity aerobic activity per week, 75 minutes of vigorous-intensity aerobic activity per week, or an equivalent combination. Aerobic activity should be performed in at least minute bouts and preferably spread throughout the week. For additional health benefits, adults should engage in minutes of moderate-intensity aerobic activity per week, minutes of vigorous-intensity aerobic activity per week, or an equivalent combination.

Additional health benefits are gained by increasing physical activity above this amount. Adults should perform muscle-strengthening activities that are moderate to high intensity and involve all major muscle groups at least twice per week, because these activities are associated with health benefits. Information from reference The benefits of physical activity on reducing cardiovascular events and mortality have also been demonstrated in men with diabetes.

A subset of 2, men in the Health Professionals Follow-up Study with self-reported type 2 diabetes at 30 years or older were grouped into quintiles of physical activity and followed for 14 years. Recommendations for physical activity should be tailored to individual patients' long-term goals. Various examples of physical activity and their associated levels of intensity are provided in Table 4.

Inactive adults who are otherwise healthy can gradually increase their activity to moderate intensity without consulting a physician. Tai chi. Yoga or Pilates. General gardening. Walking briskly 3 mph. Racewalking, jogging, or running. Sport fishing. Information from references 23 and Research on the effect of combined dietary and physical activity interventions on cardiovascular events suggests that there may be more benefit than with either intervention alone.

In addition to CVD risk, they should consider other factors, such as a patient's readiness to change, social support, and community resources that can provide support. Benefits of counseling interventions may be more pronounced in groups at higher cardiovascular risk. A Cochrane review of 55 RCTs reporting on pooled data for multiple counseling and educational methods showed no effect on primary prevention of all-cause or cardiovascular mortality or cardiovascular events.

The USPSTF found four good-quality trials involving more than 3, patients with cardiovascular risk factors that evaluated combined lifestyle-counseling interventions promoting healthy diet and physical activity.

None of the trials showed a reduction in mortality or cardiovascular events. One trial that did show benefit had high baseline rates of CVD and allowed for pharmacologic therapy in patients who did not respond to counseling. Effective counseling strategies have involved face-to-face sessions with information on diet and physical activity and behavioral change strategies, typically delivered by dietitians or health educators. Search terms included sports medicine, cardiovascular disease diet treatment, cardiovascular disease exercise treatment, and prevention cardiovascular disease exercise.

We searched updated clinical recommendations from the American Heart Association and the U. Preventive Services Task Force. We also performed bibliographic searches of practice recommendations to identify additional primary literature sources. Search dates: March 30 and December 15, , and October 27, The authors thank Mrs. The opinions and assertions contained in this article are strictly those of the authors and are not to be construed as representing official policy of the U.

Army, the Department of Defense, or the U. Already a member or subscriber? Log in. Address correspondence to Jeffrey B. Lanier, MD, U. Knox, KY e-mail: jeffrey. Reprints are not available from the authors.

Yoon PW, et al. Potentially preventable deaths from the five leading causes of death—United States, —

A Review of Obesity, Physical Activity, and Cardiovascular Disease

Regular physical activity helps improve overall health and reduces the risk for heart disease, stroke, and premature death. To prevent cardiovascular disease, the U. Physical activity can also help people with cardiovascular disease manage their conditions; exercise training has been shown to have a positive effect on people with certain types of heart failure, and cardiac rehabilitation, which includes physical activity training, helps improve the health of people who have had a heart attack or bypass surgery. Despite the substantial health benefits of physical activity one out of every four U. There are evidence-based strategies to promote physical activity that can be put into action where people live, learn, work, and play, including behavioral counseling for adults with cardiovascular risk factors and designing safe community spaces that encourage activity.

SEAN W. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality, whereas the Dietary Approaches to Stop Hypertension DASH eating plan is associated with a reduced risk of coronary artery disease. Substituting dietary saturated fat with polyunsaturated fatty acids is associated with improved cardiovascular outcomes, although exogenous supplementation with omega-3 fatty acids does not improve cardiovascular outcomes. There is an association between increased sodium intake and cardiovascular risk, but reducing dietary sodium has not consistently shown a reduction in cardiovascular risk. Physical activity recommendations for adults are at least minutes of moderate-intensity aerobic activity per week, 75 minutes of vigorous-intensity aerobic activity per week, or an equivalent combination. Increases in physical activity by any level are associated with reduced cardiovascular risk.

Arch Intern Med. Similar results were obtained for winter LTPA. Furthermore, levels of C-reactive protein, serum amyloid A, interleukin 6, and intercellular adhesion molecule 1 were inversely and independently associated with LTPA, but not with WRPS. It further demonstrates that LTPA is associated with beneficial effects on the inflammatory response. This may represent one mechanism to explain the benefits of LTPA on coronary risk. Landmark observational studies such as the Framingham Study 3 have established a number of determinants and risk factors for atherosclerosis.


Keywords: physical activity; cardiovascular disease; coronary heart disease; measures of primary prevention, mainly regular physical activity (PA), Available online: ieee-citisia.org


Diet and Physical Activity for Cardiovascular Disease Prevention

We sought to determine whether the association between physical activity and year cardiovascular disease CVD risk varies among normal weight, overweight, and obese adults in a nationally-representative sample of the United States. A subset of 22, participants aged 30—64 years was included with no CVD history. The average age of the population was Individuals who were overweight and obese had a higher year CVD risk compared to those with normal weight 9. The association of physical activity and high year CVD risk differed by weight status.

Metrics details. Regular physical activity improves overall health, and has the capacity to reduce risk of chronic diseases and death. However, better understanding of the relationship between multiple lifestyle risk behaviours and disease outcomes is pertinent for prioritising public health messaging. The aim of this systematic review is to examine the association between physical inactivity in combination with additional lifestyle risk behaviours smoking, alcohol, diet, or sedentary behaviour for cardiovascular disease, cancer, and all-cause mortality.

This review is aimed at summarizing the new findings about the multiple benefits of exercise on cardiovascular disease CVD. We pay attention to the prevalence and risk factors of CVD and mechanisms and recommendations of physical activity. Physical activity can improve insulin sensitivity, alleviate plasma dyslipidemia, normalize elevated blood pressure, decrease blood viscosity, promote endothelial nitric oxide production, and improve leptin sensitivity to protect the heart and vessels. Besides, the protective role of exercise on the body involves not only animal models in the laboratory but also clinical studies which is demonstrated by WHO recommendations. The general exercise intensity for humans recommended by the American Heart Association to prevent CVD is moderate exercise of 30 minutes, 5 times a week.

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