Review
Effects of Physical Activity on Cardiovascular Disease

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Much attention has been directed toward lifestyle modifications as effective means of reducing cardiovascular disease risk. In particular, physical activity has been heavily studied because of its well-known effects on metabolic syndrome, insulin sensitivity, cardiovascular disease risk, and all-cause mortality. However, data regarding the effects of exercise on various stages of the atherosclerosis pathway remain conflicting. The investigators review previously published reports for recent observational and interventional trials investigating the effects of physical activity on markers of (or causal factors for) atherosclerotic burden and vascular disease, including serum lipoproteins, systemic inflammation, thrombosis, coronary artery calcium, and carotid intima-media thickness. In conclusion, the data show a correlation between physical activity and triglyceride reduction, apolipoprotein B reduction, high-density lipoprotein increase, change in low-density lipoprotein particle size, increase in tissue plasminogen activator activity, and decrease in coronary artery calcium. Further research is needed to elucidate the effect of physical activity on inflammatory markers and intima-media thickness.

Section snippets

Lipoproteins

The association between serum cholesterol and CVD outcomes is well documented in the published research.1 In particular, low-density lipoprotein (LDL) and apolipoprotein B have been correlated with the development of coronary artery disease (CAD) and CVD-related events.1, 2 Early in atherogenesis, proteoglycans within arterial walls are thought to bind LDL, which subsequently results in local inflammation and the initiation of a complex pathway toward atherogenesis.1 Therefore, reductions in

Calcification

Coronary artery calcium (CAC) is an atherosclerotic marker that is strongly linked to risk of future CVD events in adult men and women.61 Over the past decade, numerous trials have identified associations between CAC and each of physical activity, exercise intensity, and cardiorespiratory fitness. Bishop et al62 found self-reported physical activity to be independently, inversely associated with CAC in type 1 diabetics. Moreover, several investigators have noted a graded correlation between

Current Recommendations

The American Heart Association currently recommends ≥30 minutes of moderate physical activity most days of the week for primary prevention of CVD and stroke.85 The American Heart Association defines moderate activity as 40% to 60% of maximum capacity or the equivalent of brisk walking at 15 to 20 min/mi. A meta-analysis of 33 studies performed since 1995 found that subjects who engaged in the equivalent of 150 min/week of moderate-intensity activity had a 14% lower risk for coronary heart

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