title: Exercise and the cardiovascular system: clinical science and cardiovascular outcomes.
abstract: Substantial evidence has established the value of high levels of physical activity, exercise training (ET), and overall cardiorespiratory fitness in the prevention and treatment of cardiovascular diseases. This article reviews some basics of exercise physiology and the acute and chronic responses of ET, as well as the effect of physical activity and cardiorespiratory fitness on cardiovascular diseases. This review also surveys data from epidemiological and ET studies in the primary and secondary prevention of cardiovascular diseases, particularly coronary heart disease and heart failure. These data strongly support the routine prescription of ET to all patients and referrals for patients with cardiovascular diseases, especially coronary heart disease and heart failure, to specific cardiac rehabilitation and ET programs.
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.). clavie@ochsner.org.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Damon L
authors.initials: DL
authors.lastname: Swift
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Neil M
authors.initials: NM
authors.lastname: Johannsen
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Duck-Chul
authors.initials: DC
authors.lastname: Lee
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Earnest
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: James H
authors.initials: JH
authors.lastname: O'Keefe
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Richard V
authors.initials: RV
authors.lastname: Milani
authors.affiliation: From the Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA (C.J.L., R.V.M.); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (R.A.); Department of Kinesiology, East Carolina University, Greenville, NC (D.L.S.); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA (N.M.J., T.S.C.); School of Kinesiology, Louisiana State University, Baton Rouge (N.M.J.); Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia (X.S., S.N.B.); Department of Kinesiology, College of Human Sciences, Iowa State University, Ames (D.c.L.); Department of Health and Kinesiology, Texas A&M University, College Station (C.P.E.); and Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O.).
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D000375:Aging / Q000502:physiology; D002302:Cardiac Output; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D002320:Cardiovascular Physiological Phenomena; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000009:adverse effects / Q000592:standards; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D009765:Obesity / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D010809:Physical Fitness; D055656:Prescriptions; D012307:Risk Factors; D057185:Sedentary Behavior; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D013318:Stroke Volume; D059289:Vascular Stiffness
keywords: body mass index; cardiovascular diseases; exercise; heart failure; metabolic equivalent