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      Exercise Training: The Holistic Approach in Cardiovascular Prevention

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          Abstract

          Nowadays, there are robust clinical and pathophysiological evidence supporting the beneficial effects of physical activity on cardiovascular (CV) system. Thus, the physical activity is considered a key strategy for CV prevention. In fact, exercise training exerts favourable effects on all risk factors for CV diseases (i.e. essential hypertension, type 2 diabetes mellitus, hypercholesterolemia, obesity, metabolic syndrome, etc…). In addition, all training modalities such as the aerobic (continuous walking, jogging, cycling, etc.) or resistance exercise (weights), as well as the leisure-time physical activity (recreational walking, gardening, etc) prevent the development of the major CV risk factors, or delay the progression of target organ damage improving cardio-metabolic risk. Exercise training is also the core component of all cardiac rehabilitation programs that have demonstrated to improve the quality of life and to reduce morbidity in patients with CV diseases, mostly in patients with coronary artery diseases. Finally, it is still debated whether or not exercise training can influence the occurrence of atrial and ventricular arrhythmias. In this regard, there is some evidence that exercise training is protective predominantly for atrial arrhythmias, reducing the incidence of atrial fibrillation. In conclusion, the salutary effects evoked by physical acitvity are useful in primary and secondary CV prevention.

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          Most cited references201

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          Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

          Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.
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            2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

            Circulation
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              2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society.

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                Author and article information

                Contributors
                carmine.morisco@unina.it
                Journal
                High Blood Press Cardiovasc Prev
                High Blood Press Cardiovasc Prev
                High Blood Pressure & Cardiovascular Prevention
                Springer International Publishing (Cham )
                1120-9879
                1179-1985
                1 November 2021
                1 November 2021
                2021
                : 28
                : 6
                : 561-577
                Affiliations
                [1 ]GRID grid.4691.a, ISNI 0000 0001 0790 385X, Department of Translational Medical Sciences, , “Federico II” University of Naples, ; 80131 Naples, Italy
                [2 ]GRID grid.4691.a, ISNI 0000 0001 0790 385X, Department of Advanced Biomedical Sciences, , “Federico II” University of Naples, ; 80131 Naples, Italy
                [3 ]Department of Cardiology, “Santa Maria della Pietà” Hospital (ASL Napoli 3 Sud), 80035 Nola, NA Italy
                Author information
                http://orcid.org/0000-0002-2158-6317
                Article
                482
                10.1007/s40292-021-00482-6
                8590648
                34724167
                1e7bb509-93a3-4e1d-b59b-5e35bb66b10e
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 30 September 2021
                : 23 October 2021
                Categories
                Review Article
                Custom metadata
                © Italian Society of Hypertension 2021

                type 2 diabetes,insulin resistance,sympathetic nervous system,ischemic preconditioning,physical activity,leisure-time physical activity,cardiac rehabilitation,secondary prevention,atrial fibrillation

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