Cardiovascular Disease

Overview

Cardiovascular Diseases include those that have had an MI,revascularization, angina, atrial fibrillation, pacemakers and implanted defibrillators, valvular heart disease, chronic heart failure, cardiac transplant, hypertension. peripheral arterial disease and aneurysms.

Total CVD mortality declined by 68% between 1980 and 2013 in the UK. Similar decreases were seen for coronary heart disease and stroke (Bhatnagar et al, 2016)

Exercise Intensity Considerations for clients with Cardiac Disease

• Deconditioned and low capacity clients may need to start at low intensities
• Target intensity should fall 10-15 beats per minute below a heart rate that has previously elicited abnormal clinical symptoms (ie chest pain or other angina symptoms)
• β-blockers and other heart rate-lowering medications will decrease the accuracy of exercise intensity prescription methods based on an age-predicted maximal heart rate
• RPE levels of 11 to 13 typically respond to the target heart rate for cardiac clients frst initiating an exercise program, RPE can be progressed (14-16) after several months of training when conditioning has improved and no complications are present.

References

American College of Sports Medicine (2009) ACSM's Resources for the personal trainer. Philadelphia, PA: Lippincott, Williams & Wilkins

Bhatnagar, P., Wickramasinghe, K., Wilkins, E., & Townsend, N. (2016). Trends in the epidemiology of cardiovascular disease in the UK. Heart, 102(24), 1945-1952. http://dx.doi.org/10.1136/heartjnl-2016-309573

Mora, S., Lee, I. M., Buring, J. E., & Ridker, P. M. (2006). Association of physical activity and body mass index with novel and traditional cardiovascular biomarkers in women. JAMA, 295(12), 1412-1419. doi:10.1001/jama.295.12.1412

Related Links on this website

Cardiac Rehabilitation

Further Reading: Textbooks

Cameron, M., Selig, S., & Hemphill, D. (2011). Clinical Exercise: a case-based approach. Elsevier Australia.

Moore, G., Durstine, J. L., Painter, P., & American College of Sports Medicine. (2016). ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities, 4E. Human Kinetics.

Further Reading: Journal Articles

Åkesson, A., Larsson, S. C., Discacciati, A., & Wolk, A. (2014). Low-risk diet and lifestyle habits in the primary prevention of myocardial infarction in men: a population-based prospective cohort study. Journal of the American College of Cardiology, 64(13), 1299-1306. https://doi.org/10.1016/j.jacc.2014.06.1190

Archer, E., & Blair, S. N. (2011). Physical activity and the prevention of cardiovascular disease: from evolution to epidemiology. Progress in cardiovascular diseases, 53(6), 387-396. [full text]

Carabello, B. A. (2002). Evaluation and management of patients with aortic stenosis. Circulation, 105(15), 1746-1750. [full text]

Davies, E.J., Moxham, T., Rees, K., Singh, S., Coats, A.J.S., Ebrahim, S., Lough, F., Taylor, R.S.(2010) Exercise based rehabilitation for heart failure. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD003331. DOI: 10.1002/14651858.CD003331.pub3 [full text]

Fletcher, G.F., Balady, G.J., Amsterdam, E.A., et al (2001) Exercise Standards for Testing and Training: A Statement for Healthcare Professionals from the American Heart Association. Circulation, Vol. 104, 1694-1740 [full text]

Green, D. J., Hopman, M. T., Padilla, J., Laughlin, M. H., & Thijssen, D. H. (2017). Vascular adaptation to exercise in humans: role of hemodynamic stimuli. Physiological Reviews, 97(2), 495-528. https://doi.org/10.1152/physrev.00014.2016

Heran, B. S., Chen, J. M., Ebrahim, S., Moxham, T., Oldridge, N., Rees, K., ... & Taylor, R. S. (2011). Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev, 7(7). [full text]

Leon, A.S., Franklin, B.A., Costa, F., Balady, G.J., Berra, K.A., Stewart, K.J., et al. (2005) Cardiac rehabilitation and secondary prevention of coronary artery disease:an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary rehabilitation. Circulation 111:369–376 [full text]

Pischke, C. R., Scherwitz, L., Weidner, G., & Ornish D. (2008) Long-term effects of lifestyle changes on well-being and cardiac variables among CHD patients. Health Psychology.Vol.27, No.5, 584-92 [author’s text]

Thompson, P. D., Buchner, D., Piña, I. L., Balady, G. J., Williams, M. A., Marcus, B. H., ... & Wenger, N. K. (2003). Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation, 107(24), 3109-3116 [full text]

Further Reading: Online

American Heart Association - www.americanheart.org

BBC Health microsite - [click here]

Fisher, K. and Jamnik, R. (2007) Exercise and medication: How do they interact? [www]

Peel, C., & Mossberg, K. A. (1995). Effects of cardiovascular medications on exercise responses. Physical therapy, 75(5), 387-396.[full text]