Regular Exercise for Cardiovascular Disease Patients: More is Better

Researchers here analyze epidemiological data to find that cardiovascular disease patients have a better prognosis the more that they exercise. In terms of improved health, cardiovascular disease patients can achieve greater relative mortality reductions from higher levels of exercise than is the case for healthy individuals, which is an interesting finding. As always, it is worth remembering that this data shows correlation rather than causation. Animal studies make it clear that exercise is beneficial, but in human data there is room to argue that other factors are at work, such as the possibility that people with less severe cardiovascular disease (and thus lower mortality risk) will tend to exercise more than those with worse cardiovascular disease (and thus worse mortality risk).

There is debate to whether cardiovascular health status affects the dose-response association between physical activity (PA) and health outcomes. Studies among patients with cardiovascular diseases (CVDs) found different associations between PA and mortality reductions, which were described as linear, J shaped, or U shaped.

A cohort study (median follow-up 6.8 years) was performed comparing the association between moderate to vigorous physical activity (MVPA) and incident major adverse cardiovascular events (MACE) and all-cause mortality between healthy individuals (n = 112,018), individuals with cardiovascular risk factors (CVRF) (n = 27,982), and CVD (n = 2,493). The shape of dose-response association between MVPA and cardiovascular events and death is curvilinear for healthy individuals and those with CVRF, whereas a linear relationship was found in individuals with CVDs. The association between MVPA and the risk of CVD or mortality is domain specific as leisure activities were associated with the most benefits, nonleisure activities with little benefits, and occupational activities with no benefits.

In conclusion, MVPA is associated with risk reductions in all groups, but, especially, CVD patients should be encouraged that "more is better" regarding PA. PA recommendations could be optimized by taking cardiovascular health status and the domain of MVPA into account.


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