Physical Activity, Cardiorespiratory Fitness, and Atherosclerotic Cardiovascular Disease: Part 2.

IF 3.8 Q1 PERIPHERAL VASCULAR DISEASE Pulse Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.1159/000541166
Barry A Franklin, Sae Young Jae
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Abstract

Background: In this second section of our 2-part review on the role of physical activity (PA) and cardiorespiratory fitness (CRF) in preventing and treating atherosclerotic cardiovascular disease (CVD), we expand on topics covered in part 1, including a comparison of moderate-intensity continuous training versus high-intensity interval training, the beneficial role of PA and CRF in heart failure, potential mal-adaptations that may result from extreme endurance exercise regimens, and the incidence of cardiac arrest and sudden cardiac death during marathon running and triathlon participation. Further, we review the principles of exercise prescription for patients with known or suspected CVD, with specific reference to exercise modalities, contemporary guidelines, the minimum exercise training intensity to promote survival benefits, and long-term goal training intensities, based on age-, sex-, and fitness-adjusted targets. Finally, we provide practical "prescription pearls" for the clinician, including a simple rule to estimate metabolic equivalents (METs) during level and graded treadmill walking, research-based exercise training recommendations, using steps per day, MET-minutes per week, and personal activity intelligence to achieve beneficial treatment outcomes, as well as the heart rate index equation to estimate energy expenditure, expressed as METs, during recreational and leisure-time PA.

Summary: This review compares moderate-intensity continuous training and high-intensity interval training, examines the role of PA and CRF in managing heart failure, and discusses the cardiovascular risks associated with extreme endurance exercise. It also provides practical guidelines for exercise prescription tailored to patients with CVD, highlighting advanced exercise prescription strategies to optimize cardiovascular health.

Key messages: Physicians and healthcare providers should prioritize referring patients to home-based or medically supervised exercise programs to leverage the cardioprotective benefits of regular PA. For most inactive patients, an exercise prescription is essential for improving overall health.

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体育锻炼、心肺功能和动脉粥样硬化性心血管疾病:第 2 部分。
背景:在这篇由两部分组成的综述的第二部分中,我们探讨了体力活动(PA)和心肺功能(CRF)在预防和治疗动脉粥样硬化性心血管疾病(CVD)中的作用,并对第一部分中涉及的主题进行了扩展,包括中等强度持续训练与高强度间歇训练的比较、体力活动和心肺功能在心力衰竭中的有益作用、极端耐力运动方案可能导致的潜在适应不良,以及马拉松和铁人三项运动中心脏骤停和心脏性猝死的发生率。此外,我们还回顾了为已知或疑似心血管疾病患者开运动处方的原则,特别提到了运动方式、当代指南、促进生存益处的最低运动训练强度,以及基于年龄、性别和体能调整目标的长期目标训练强度。最后,我们为临床医生提供了实用的 "处方珍珠",包括在水平和分级跑步机上行走时估算代谢当量(METs)的简单规则,基于研究的运动训练建议,使用每天步数、每周 MET 分钟和个人活动智能来实现有益的治疗效果,以及心率指数方程来估算娱乐和休闲时间 PA 的能量消耗(以 METs 表示)。摘要:这篇综述比较了中等强度的持续训练和高强度的间歇训练,探讨了 PA 和 CRF 在控制心力衰竭中的作用,并讨论了与极限耐力运动相关的心血管风险。报告还提供了针对心血管疾病患者的运动处方实用指南,强调了优化心血管健康的先进运动处方策略:医生和医疗保健提供者应优先将患者转诊至家庭或医疗监督下的运动项目,以充分利用定期运动对保护心脏的益处。对于大多数不运动的患者来说,运动处方对于改善整体健康至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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