Impact of educational interventions on primary prevention of cardiovascular disease: A systematic review with a focus on physical activity.

BACKGROUND: Evidence from epidemiological and experimental studies illustrates the beneficial impact of healthy lifestyle behaviours on cardiovascular risk. OBJECTIVES: To assess the effectiveness of primary care health education interventions designed to promote healthy lifestyles on physical activity levels and cardiovascular risk. METHODS: A computer-aided search on PubMed and Scopus was performed to identify relevant studies published from January 2000 to October 2016. Two authors independently selected studies for inclusion and extracted data, including intervention characteristics and outcome measures, namely physical activity and cardiovascular risk or risk factors. RESULTS: Of the 212 identified studies, 15 met the inclusion criteria. The 15 studies enrolled 6727 participants; the sample size varied between 74 and 878 adults. Fourteen studies assessed physical activity by questionnaire and only one study used accelerometry. Eight of the 15 studies showed improvements in the physical activity levels after the intervention, ranging from 5% to 26% in those where significant changes between groups were detected. Most studies reported significant positive effects of the health education interventions on cardiovascular risk factors, mainly on lipid profile, blood pressure and cardiovascular risk score. CONCLUSION: The health education interventions, in primary care, seem to improve daily physical activity, cardiovascular risk factors and risk score.

Physical activity in primary and secondary prevention of cardiovascular disease: Overview updated.

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.

Treadmill walking with load carriage increases aortic pressure wave reflection.

INTRODUCTION AND OBJECTIVES: The study examined the effects of treadmill walking with load carriage on derived measures of central pressure and augmentation index in young healthy subjects. METHODOLOGY: Fourteen male subjects (age 31.0 ± 1.0 years) volunteered in this study. Subjects walked 10 minutes on a treadmill at a speed of 5 km/h carrying no load during one session and a load of 10% of their body weight on both upper limbs in two water carboys with handle during the other session. Pulse wave analysis was performed at rest and immediately after exercise in the radial artery of the right upper limb by applanation tonometry. RESULTS: The main result indicates that walking with load carriage sharply increased augmentation index at 75 bpm (-5.5 ± 2.2 to -1.4 ± 2.2% vs. -5.2 ± 2.8 to -5.5 ± 2.1%, p<0.05), and also induced twice as high increments in central pulse pressure (7.4 ± 1.5 vs. 3.1 ± 1.4 mmHg, p<0.05) and peripheral (20.5 ± 2.7 vs. 10.3 ± 2.5 mmHg, p<0.05) and central systolic pressure (14.7 ± 2.1 vs. 7.4 ± 2.0 mmHg, p<0.05). CONCLUSIONS: Walking with additional load of 10% of their body weight (aerobic exercise accompanied by upper limb isometric contraction) increases derived measures of central pressure and augmentation index, an index of wave reflection and arterial stiffness.

Effects of exercise training on endothelial progenitor cells in cardiovascular disease: a systematic review.

This review aimed to examine the effects of exercise training on mobilization of endothelial progenitor cells (EPCs) in patients with cardiovascular disease and to discuss the possible mechanisms involved in the process. A computer-aided search on PubMed and PEDro was conducted to identify relevant studies published up to June 2012. Two reviewers independently selected studies for inclusion and extracted data, namely, quantitative assessment of circulating EPCs. Of the 88 identified studies, 13 met the inclusion criteria. The 13 studies enrolled 648 participants, including patients with chronic heart failure, peripheral artery disease, and coronary artery disease. The exercise characteristics varied largely across the studies: exercise duration ranged from 2 wks to 6 mos, session duration ranged from 20 to 60 mins, and exercise intensity was usually calculated using the maximal heart rate (ranging from 75% to 85%) or the peak/maximum oxygen consumption (60%-70%). All studies used aerobic exercise. The great majority of the 13 studies reported significant effects of different exercise regimens on the number of circulating EPCs. In summary, exercise training seems to increase the number of circulating EPCs, which could contribute to vascular regeneration and angiogenesis. These positive effects of chronic exercise seem to be closely related to the bioavailability of nitric oxide, including increased activity of endothelial nitric oxide synthase and antioxidant enzymes, and activation of matrix metalloproteinase 9.

Excess postexercise oxygen consumption is unaffected by the resistance and aerobic exercise order in an exercise session.

The main purpose of this study was to compare the magnitude and duration of excess postexercise oxygen consumption (EPOC) after 2 exercise sessions with different exercise mode orders, resistance followed by aerobic exercise (R-A); aerobic by resistance exercise (A-R). Seven young men (19.6 ± 1.4 years) randomly underwent the 2 sessions. Aerobic exercise was performed on a treadmill for 30 minutes (80-85% of reserve heart rate). Resistance exercise consisted of 3 sets of 10 repetition maximum on 5 exercises. Previous to the exercise sessions, V(O2), heart rate, V(CO2), and respiratory exchange rate (RER) were measured for 15 minutes and again during recovery from exercise for 60 minutes. The EPOC magnitude was not significantly different between R-A (5.17 ± 2.26 L) and A-R (5.23 ± 2.48 L). Throughout the recovery period (60 minutes), V(O2) and HR values were significantly higher than those observed in the pre-exercise period (p < 0.05) in both exercise sessions. In the first 10 minutes of recovery, V(CO2) and RER declined to pre-exercise levels. Moreover, V(CO2) and RER values in A-R were significantly lower than in R-A. In conclusion, the main result of this study suggests that exercise mode order does not affect the EPOC magnitude and duration. Therefore, it is not necessary for an individual to consider the EPOC when making the decision as to which exercise mode is better to start a training session.