Leisure Time Physical Activity In Patients Research Articles

Effect of Changes in Physical Activity on Risk for Cardiac Death in Patients With Coronary Artery Disease

Leisure-time physical activity (LTPA) is associated with longevity in patients with coronary artery disease (CAD). However, less is known about prognostic significance of longitudinally assessed LTPA in patients with stable CAD. The present study assessed the relationship between changes in LTPA and cardiac mortality in patients with CAD. Patients with angiographically documented CAD (n = 1,746) underwent clinical examination and echocardiography at the baseline. Lifestyle factors, including LTPA (inactive, irregularly active, active, highly active), were surveyed at baseline and after 2 years' follow-up. Thereafter, the patients entered the follow-up (median: 4.5 years; first to third quartile: 3.4 to 5.8 years) during which cardiac deaths were registered (n = 68, 3.9%). The patients who remained inactive (n = 114, 18 events, 16%) and became inactive (n = 228, 18 events, 8%) had 7.6- (95% confidence interval [CI] 4.2 to 13.6) and 3.7-fold (95% CI 2.1 to 6.7) univariate risk for cardiac death compared with those who remained at least irregularly active (n = 1,351, 30 events, 2%), respectively. After adjustment for age, gender, body mass index, diabetes, previous myocardial infarction, left ventricular ejection fraction, angina pectoris grading, cardiovascular event during initial 2-year follow-up, smoking and alcohol consumption, the patients who remained inactive and became inactive still had 4.9- (95% CI 2.4 to 9.8, p <0.001) and 2.4-fold (95% CI 1.3 to 4.5, p <0.01) risk for cardiac death, respectively, compared with patients remaining at least irregularly active. In conclusion, LTPA has important prognostic value for cardiac death in patients with stable CAD. Even minor changes in LTPA over 2 years were related to the subsequent risk for cardiac death.

Competitive sports and leisure-time physical activity in patients with coronary heart disease

During recent years, the central role of exercise in the prevention of cardiovascular disease has gradually been demonstrated, and in 2003 the consensus document of the Council on Clinical Cardiology and Council on Nutrition, Physical Activity and Metabolism on the role of physical exercise in the prevention and treatment of coronary artery disease defined sedentary lifestyle as a modifiable independent cardiovascular risk factor, responsible for 12% of total mortality in the United States and for a 1.9-fold increase in the risk of ischemic heart disease. The reduction in cardiovascular mortality and cardiac ischemic events in subjects who perform regular physical activity is mainly due to the action that exercise plays on the control of cardiovascular risk factors. In particular, physical training has proved capable of improving lipid profile, reducing blood pressure and body weight, and improving glycemic control in diabetic subjects. In patients with coronary artery disease, combined exercise training, including both aerobic activities and strength training, is currently recommended. However, physical training in patients suffering from ischemic heart disease should be carefully prescribed, in order to maximize the positive effects and minimize the risks. It is also important that physical training programs are conducted in suitable facilities, with appropriately trained staff and with technical equipment suitable to deal with any emergency situations.