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World J Cardiol. Oct 26, 2016; 8(10): 575-583
Published online Oct 26, 2016. doi: 10.4330/wjc.v8.i10.575
Physical activity in primary and secondary prevention of cardiovascular disease: Overview updated
Alberto J Alves, João L Viana, Suiane L Cavalcante, Nórton L Oliveira, José A Duarte, Jorge Mota, José Oliveira, Fernando Ribeiro
Alberto J Alves, João L Viana, Research Centre in Sports Sciences, Health and Human Development, CIDESD, University Institute of Maia, 4475-690 Maia, Portugal
Suiane L Cavalcante, Nórton L Oliveira, José A Duarte, Jorge Mota, José Oliveira, Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
Fernando Ribeiro, School of Health Sciences and Institute of Biomedicine, iBiMED, University of Aveiro, 3810-193 Aveiro, Portugal
Author contributions: Alves AJ contributed to writing and reviewing the literature; Viana JL, Cavalcante SL, Oliveira NL, Duarte JA, Mota J and Oliveira J contribute to design and writing; Ribeiro F provided overall study supervision.
Conflict-of-interest statement: Alberto J Alves and others authors declare no conflict of interest related to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alberto J Alves, PhD, Research Center in Sports Sciences, Health and Human Development, CIDESD, University Institute of Maia, Av. Carlos Oliveira Campos - Castelo da Maia, 4475-690 Maia, Portugal. ajalves@ismai.pt
Telephone: +351-22-9866000-1313
Received: June 16, 2016
Peer-review started: June 17, 2016
First decision: July 4, 2016
Revised: July 14, 2016
Accepted: August 17, 2016
Article in press: August 18, 2016
Published online: October 26, 2016
Processing time: 132 Days and 10.6 Hours
Abstract

Although the observed progress in the cardiovascular disease treatment, the incidence of new and recurrent coronary artery disease remains elevated and constitutes the leading cause of death in the developed countries. Three-quarters of deaths due to cardiovascular diseases could be prevented with adequate changes in lifestyle, including increased daily physical activity. New evidence confirms that there is an inverse dose-response relationship between physical activity and cardiovascular disease and mortality risk. However, participation in moderate to vigorous physical activity may not fully attenuate the independent effect of sedentary activities on increased risk for cardiovascular diseases. Physical activity also plays an important role in secondary prevention of cardiovascular diseases by reducing the impact of the disease, slowing its progress and preventing recurrence. Nonetheless, most of eligible cardiovascular patients still do not benefit from secondary prevention/cardiac rehabilitation programs. The present review draws attention to the importance of physical activity in the primary and secondary prevention of cardiovascular diseases. It also addresses the mechanisms by which physical activity and regular exercise can improve cardiovascular health and reduce the burden of the disease.

Keywords: Physical activity; Primary prevention; Secondary prevention; Cardiovascular disease; Health care evaluation mechanisms

Core tip: This review describes the benefits of physical activity in primary and secondary prevention of cardiovascular disease. Physical inactivity is related to high blood cholesterol and accumulation of visceral fat, accompanied by low-grade vascular inflammation, which in turn is associated with insulin resistance and atherosclerosis leading to the development of coronary artery disease. In contrast, physical activity decreases vascular inflammation, and improves endothelial function and coronary circulation, preventing myocardial ischemia. Health professionals and policy makers in public health should align strategies to increase participation in physical activity.