The Present and Future
Council Perspectives
Exercise at the Extremes: The Amount of Exercise to Reduce Cardiovascular Events

https://doi.org/10.1016/j.jacc.2015.11.034Get rights and content
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Abstract

Habitual physical activity and regular exercise training improve cardiovascular health and longevity. A physically active lifestyle is, therefore, a key aspect of primary and secondary prevention strategies. An appropriate volume and intensity are essential to maximally benefit from exercise interventions. This document summarizes available evidence on the relationship between the exercise volume and risk reductions in cardiovascular morbidity and mortality. Furthermore, the risks and benefits of moderate- versus high-intensity exercise interventions are compared. Findings are presented for the general population and cardiac patients eligible for cardiac rehabilitation. Finally, the controversy of excessive volumes of exercise in the athletic population is discussed.

Key Words

athletes
cardiac patients
coronary artery disease
health
heart failure
longevity
mortality
myocardial infarction
physical activity

Abbreviations and Acronyms

CAC
coronary artery calcification
CVD
cardiovascular disease
HIIT
high-intensity interval training
IQR
interquartile range
MET
metabolic equivalent of task score
MI
myocardial infarction
MICT
moderate intensity continuous training
QOL
quality of life
SCD
sudden cardiac deaths

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The views expressed in this paper by the American College of Cardiology's (ACC's) Sports and Exercise Cardiology Leadership Council do not necessarily reflect the views of the Journal of the American College of Cardiology or the ACC.

Dr. Eijsvogels is supported by a European Commission Horizon 2020 grant (Marie Sklodowska-Curie Fellowship 655502). Dr. Thompson has received research support from the National Institutes of Health, Genomas, Aventis, Roche, Sanofi, Regeneron, Esperion, Amarin and Pfizer; has served as a consultant for Amgen, AstraZeneca, Regeneron, Merck, Genomas, Abbott, Pfizer, Esperion, and Sanofi; has received speaker honoraria from Merck, AstraZeneca, Regeneron, Sanofi, and Amgen; owns stock in Abbvie, Abbott Laboratories, CVS, General Electric, Johnson & Johnson, Medtronic, and JA Wiley; and has provided expert legal testimony on exercise-related cardiac events and statin myopathy. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Listen to this manuscript's audio summary by JACC Editor-in-Chief Dr. Valentin Fuster.