Cardiovascular benefits and risks of exercise

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Habitual physical activity is known to reduce the risk of future cardiovascular morbidity and mortality. However, recent studies revealed that extreme physical activity patterns (i.e. prolonged sitting or performance of endurance exercise) may be associated with an increased cardiovascular risk. Dr Thijs Eijsvogels (Dept. of Physiology) and colleagues (Liverpool / Hartford) summarized the evidence for the cardiovascular benefits and risks across the physical activity spectrum.
Their manuscript was published in the September issue of Current Opinion on Cardiology. Prolonged sitting appeared to be highly prevalent in the general population (~7hrs/day) and increases the risk for cardiovascular mortality. Breaking-up of prolonged sitting time or replacement of sitting time by (light) physical activity can effectively reduce the detrimental effects of sitting. Sit-to-stand desks and standing/walking meetings may be effective workplace health interventions to reduce the amount of sedentary time. Alternatively, one may increase their exercise activities. Low doses of exercise (15 min/day) already improve health, but higher doses give larger benefits. Current guidelines prescribe moderate-intensity activities (i.e. walking/cycling) for 150 min/week and yield a 31% risk reduction in all-cause mortality. Interestingly, high-intensity activities (i.e. running/rowing) appeared to induce larger risk reductions compared to moderate-intensity activities of a similar volume. Due to the increasing number of participants in endurance exercise events, the authors also explored the effects of extreme exercise on the heart. Frequent exercise training cause cardiac remodeling which results in enlargement of all cardiac chambers: a benign phenomenon. Nevertheless, performance of endurance exercise also leads to transient cardiac dysfunction and an increase of cardiac biomarker concentrations such as troponins. Recovery was observed within 24-48 hours post-exercise. Although athletes had an increased risk for atrial fibrillation, long-term prognosis are good as they live 4-6 years longer compared to individuals from the general population.

Publication: Eijsvogels TM, George KP, Thompson PD, “Cardiovascular benefits and risks across the physical activity continuum”, Current Opinion in Cardiology, http://www.ncbi.nlm.nih.gov/pubmed/27455432


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