Elsevier

Progress in Cardiovascular Diseases

Volume 61, Issues 5–6, November–December 2018, Pages 484-490
Progress in Cardiovascular Diseases

An Update on the Role of Cardiorespiratory Fitness, Structured Exercise and Lifestyle Physical Activity in Preventing Cardiovascular Disease and Health Risk

https://doi.org/10.1016/j.pcad.2018.11.005Get rights and content

Abstract

The cardiovascular disease (CVD) pandemic has placed considerable strain on healthcare systems, quality of life, and physical function, while remaining the leading cause of death globally. Decades of scientific investigations have fortified the protective effects of cardiorespiratory fitness (CRF), exercise training, and physical activity (PA) against the development of CVD. This review will summarize recent efforts that have made significant strides in; 1) the application of novel analytic techniques to increase the predictive utility of CRF; 2) understanding the protective effects of long-term compliance to PA recommendations through large cohort studies with multiple points of assessment; 3) and understanding the potential harms associated with extreme volumes of PA.

Introduction

Cardiorespiratory fitness (CRF) is now viewed as an important vital sign, providing valuable insight into health and prognosis.1., 2., 3., 4. Participating in structured exercise and lifestyle physical activity (PA) have long been held as behaviors that may protect against the development of cardiovascular (CV) diseases (CVD) or prevent recurrent CVD related events independent of an individual's age, sex, and race. The collective investigative efforts, starting with the seminal works by Morris et al.5 and Paffenbarger et al.,6,7 have produced high quality epidemiological, randomized controlled, and observational investigations that refined our understanding of the minimal and potentially upper limits of PA volume required to reduce CVD risk. All forms of PA, whether structured or unstructured, promote enhancing physical and physiologic function, and CRF, and ultimately protect against CVD and CVD related events. This review provides an update on the latest results from investigations reporting on the effects of CRF, structured exercise and PA volume on the risk of developing CVD and suffering untoward events across the health spectrum.

Section snippets

Cardiorespiratory fitness

The measure of an individual's peak/maximal capacity to perform physical, aerobic work is dependent on the synergistic working of key organ systems that deliver oxygen from the ambient air to the mitochondria, while effectively removing metabolic byproducts that when accumulated, impair efforts to sustain or increase intensity. This process is a primary reflection of an individual's CRF, which can be objectively assessed by quantifying the volume of oxygen consumed per minute (i.e., VO2) or

Exercise training (ET)

Regular, purposeful aerobic and/or strength ET confers multi-systemic adaptations that optimize physiologic function, CRF, and expands the life- and healthspan.39 The accumulation of health benefits associated with ET contributes to reducing the presence of CVD risk factors and CVD itself. Recently, several studies have provided insight into the long-term effects of ET. An examination of lifelong exercise participation according to quintiles (Q) of exercise dose (Q1: ≤491, Q2: 492–771, Q3:

Summary

The latest studies reporting on the associations between CRF, structured ET and leisure PA with risk for CVD and poor health outcomes, discussed in this review, confirm and extend previous findings by providing greater insight into the effects of long-term maintenance of CRF, exercise training and PA on CVD outcomes in large scale studies. Despite the robust associations between these measures and reduced risk of CVD, physical inactivity and associated healthcare costs remains high. Promising

Statement of Conflict of Interest

None of the authors have any conflicts of interests with regard to this publication.

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