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Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients.

Abstract

BACKGROUND

Exercise performed at higher relative intensities has been found to elicit a greater increase in aerobic capacity and greater cardioprotective effects than exercise at moderate intensities. An inverse association has also been detected between the relative intensity of physical activity and the risk of developing coronary heart disease, independent of the total volume of physical activity. Despite that higher levels of physical activity are effective in reducing cardiovascular events, it is also advocated that vigorous exercise could acutely and transiently increase the risk of sudden cardiac death and myocardial infarction in susceptible persons. This issue may affect cardiac rehabilitation.

METHODS AND RESULTS

We examined the risk of cardiovascular events during organized high-intensity interval exercise training and moderate-intensity training among 4846 patients with coronary heart disease in 3 Norwegian cardiac rehabilitation centers. In a total of 175 820 exercise training hours during which all patients performed both types of training, we found 1 fatal cardiac arrest during moderate-intensity exercise (129 456 exercise hours) and 2 nonfatal cardiac arrests during high-intensity interval exercise (46 364 exercise hours). There were no myocardial infarctions in the data material. Because the number of high-intensity training hours was 36% of the number of moderate-intensity hours, the rates of complications to the number of patient-exercise hours were 1 per 129 456 hours of moderate-intensity exercise and 1 per 23 182 hours of high-intensity exercise.

CONCLUSIONS

The results of the current study indicate that the risk of a cardiovascular event is low after both high-intensity exercise and moderate-intensity exercise in a cardiovascular rehabilitation setting. Considering the significant cardiovascular adaptations associated with high-intensity exercise, such exercise should be considered among patients with coronary heart disease.

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  • Authors+Show Affiliations

    ,

    Jebsen Center of Exercise In Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. oivind.rognmo@ntnu.no

    , , , , , ,

    Source

    Circulation 126:12 2012 Sep 18 pg 1436-40

    MeSH

    Adaptation, Physiological
    Cardiac Surgical Procedures
    Coronary Disease
    Death, Sudden, Cardiac
    Exercise
    Exercise Therapy
    Female
    Health Surveys
    Heart Failure
    Heart Valve Diseases
    Humans
    Male
    Middle Aged
    Myocardial Infarction
    Norway
    Risk Factors

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22879367

    Citation

    Rognmo, Øivind, et al. "Cardiovascular Risk of High- Versus Moderate-intensity Aerobic Exercise in Coronary Heart Disease Patients." Circulation, vol. 126, no. 12, 2012, pp. 1436-40.
    Rognmo Ø, Moholdt T, Bakken H, et al. Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation. 2012;126(12):1436-40.
    Rognmo, Ø., Moholdt, T., Bakken, H., Hole, T., Mølstad, P., Myhr, N. E., ... Wisløff, U. (2012). Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation, 126(12), pp. 1436-40. doi:10.1161/CIRCULATIONAHA.112.123117.
    Rognmo Ø, et al. Cardiovascular Risk of High- Versus Moderate-intensity Aerobic Exercise in Coronary Heart Disease Patients. Circulation. 2012 Sep 18;126(12):1436-40. PubMed PMID: 22879367.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. AU - Rognmo,Øivind, AU - Moholdt,Trine, AU - Bakken,Hilde, AU - Hole,Torstein, AU - Mølstad,Per, AU - Myhr,Nils Erling, AU - Grimsmo,Jostein, AU - Wisløff,Ulrik, Y1 - 2012/08/09/ PY - 2012/8/11/entrez PY - 2012/8/11/pubmed PY - 2012/12/10/medline SP - 1436 EP - 40 JF - Circulation JO - Circulation VL - 126 IS - 12 N2 - BACKGROUND: Exercise performed at higher relative intensities has been found to elicit a greater increase in aerobic capacity and greater cardioprotective effects than exercise at moderate intensities. An inverse association has also been detected between the relative intensity of physical activity and the risk of developing coronary heart disease, independent of the total volume of physical activity. Despite that higher levels of physical activity are effective in reducing cardiovascular events, it is also advocated that vigorous exercise could acutely and transiently increase the risk of sudden cardiac death and myocardial infarction in susceptible persons. This issue may affect cardiac rehabilitation. METHODS AND RESULTS: We examined the risk of cardiovascular events during organized high-intensity interval exercise training and moderate-intensity training among 4846 patients with coronary heart disease in 3 Norwegian cardiac rehabilitation centers. In a total of 175 820 exercise training hours during which all patients performed both types of training, we found 1 fatal cardiac arrest during moderate-intensity exercise (129 456 exercise hours) and 2 nonfatal cardiac arrests during high-intensity interval exercise (46 364 exercise hours). There were no myocardial infarctions in the data material. Because the number of high-intensity training hours was 36% of the number of moderate-intensity hours, the rates of complications to the number of patient-exercise hours were 1 per 129 456 hours of moderate-intensity exercise and 1 per 23 182 hours of high-intensity exercise. CONCLUSIONS: The results of the current study indicate that the risk of a cardiovascular event is low after both high-intensity exercise and moderate-intensity exercise in a cardiovascular rehabilitation setting. Considering the significant cardiovascular adaptations associated with high-intensity exercise, such exercise should be considered among patients with coronary heart disease. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/22879367/full_citation L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.112.123117?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -