Physical Activity and Cardiorespiratory Fitness as Major Markers of Cardiovascular Risk: Their Independent and Interwoven Importance to Health Status

Myers, Jonathan; McAuley, Paul; Lavie, Carl J.; Després, Jean; Arena, Ross; Kokkinos, Peter

doi:10.1016/j.pcad.2014.09.011

Cited by 579 publications

(472 citation statements)

References 61 publications

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“…19 The interaction between cardiorespiratory fitness, type 2 diabetes, and statin use provides an additional impetus for health care providers to promote moderate physical activity in order to reduce the burden of type 2 diabetes. [26][27][28] This study has several strengths and limitations inherent in prospective follow-up studies. Importantly, cardiorespiratory fitness levels were based on only 1 assessment, and follow-up data on cardiorespiratory fitness status of the participants was not available.…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory Fitness and Incidence of Type 2 Diabetes in United States Veterans on Statin Therapy

Kokkinos

Faselis

Narayan

et al. 2017

The American Journal of Medicine

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Section: Discussionmentioning

confidence: 99%

Cardiorespiratory Fitness and Incidence of Type 2 Diabetes in United States Veterans on Statin Therapy

Kokkinos

Faselis

Narayan

et al. 2017

The American Journal of Medicine

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“…Most common in use in health studies is measurement of cardiorespiratory fitness (CRF), which reflects the ability of the body's circulatory and respiratory systems to supply oxygen during sustained physical activity. CRF thus constitutes an objective measure of aerobic activity performed over time 17, and for all‐cause mortality 18 and cardiovascular diseases (CVD) risk and mortality 19, 20 an inverse association with CRF is well established. This provides an expectation of a stronger association between CRF and cancer than found for SPA.…”

Section: Introductionmentioning

confidence: 99%

Measured cardiorespiratory fitness and self‐reported physical activity: associations with cancer risk and death in a long‐term prospective cohort study

et al. 2016

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Physical activity is inversely associated with risk of some cancers. The relation with cancer‐specific death remains uncertain. Mainly, studies on relationships between physical activity and cancer are based on self‐reported physical activity (SPA). Hereby, we examined whether measured cardiorespiratory fitness (CRF) is associated with cancer risk, mortality, and case fatality. We also describe relationships between SPA and these outcomes, and between CRF and SPA. A cohort of 1997 healthy Norwegian men, aged 40–59 years at inclusion in 1972–75, was followed throughout 2012. At baseline, CRF was objectively measured. SPA (leisure time and occupational) was obtained through a questionnaire. Relationships between CRF or SPA, and the outcomes were estimated using Cox regression, adjusted for age, body mass index (BMI), and smoking. Pearson correlation coefficients evaluated agreements between CRF and SPA. During follow‐up, 758 men were diagnosed with cancer and 433 cancer deaths occurred. Analyses revealed lower cancer risk (Hazard ratio [HR] 0.85, 95% confidence intervals [CI]: 0.68–1.00), mortality (HR 0.68, 95% CI: 0.53–0.88), and case fatality (HR 0.74, 95% CI: 0.57–0.96), in men with high CRF compared to low CRF. Light leisure time SPA was associated with lower cancer risk (HR 0.70, 95% CI: 0.56–0.86) and mortality (HR 0.64 95% CI: 0.49–0.83), whereas strenuous occupational SPA was associated with higher risks (HR 1.42, 95% CI: 1.13–1.78 and HR 1.45, 95% CI: 1.09–1.93). Correlations between CRF and SPA were 0.351 (P < 0.001) and −0.106 (P < 0.001) for leisure time and occupational SPA, respectively. A high midlife CRF may be beneficial for cancer risk, cancer mortality, and case fatality.

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“…The variability is postulated to be based on reimbursement policies. Clearly, evidence is needed to demarcate minimum dose of CR needed to significantly improve patient quality and quantity of life, with consideration of case-mix 95 , so quality of care in countries/regions not meeting this minimum can be improved.With regard to core components delivered, exercise training was the most consistently offered one overall, but also in the regions of Europe and Latin America; this is laudable given that the greatest improvements in prognosis are explained by improvements in cardiorespiratory fitness achieved through physical activity [96][97][98][99] . Clearly great efforts are needed to increase CR penetration in healthcare systems across the globe, given these are highly cost-effective strategies [100][101][102][103] .…”

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A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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Herein, 28 publications describing cardiac rehabilitation (CR) delivery in 50 of the 113 countries globally suspected to deliver it are reviewed, to characterize the nature of services. Government funding was the main source of CR reimbursement in most countries (73%), with private and patient funding in about ¼ of cases.Myocardial infarction patients and those having revascularization were commonly served. The main professions delivering CR were physicians, nurses, and physiotherapists. Programs offered a median of 20 sessions, although this varied. Most programs offered the core components of exercise training, patient education and nutrition counselling. Alternative models were not commonly offered. Lack of human and/or financial resources as well as space constraints were reported as the major barriers to delivery. Overall, CR delivery has been characterized in less than half of the countries where it is offered. The nature of services delivered is fairly consistent with major CR guidelines and statements.Keywords: cardiac rehabilitation, global health, secondary prevention Alphabetical List of Abbreviations: AS= administrative support CABG = coronary artery bypass graft CB = community-based A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT2 CR = cardiac rehabilitation CPR= cardiopulmonary resuscitation CVD = cardiovascular disease ECG = electrocardiogram EQ= equipment ET = exercise training FR= financial resources HB = home-based HF = heart failure HR= human resources IA = initial assessment IB = internet-based IHD = ischemic heart disease LMIC = low-and middle-income country MI = myocardial infarction NC = nutrition counseling NZ = New Zealand PAW= patient awareness PCI = percutaneous coronary intervention PE = patient education PR= patient referral RF = risk factor management SC = smoking cessation SM = stress management and/or psychosocial support/counselling TI = transportation issues UAE = United Arab Emirates VAD = ventricular assist device A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 By 2030, it is expected 84 million individuals will be diagnosed with cardiovascular disease (CVD) 1 .Moreover, it is among the leading causes of disability around the world, and contributes to 10% of disabilityadjusted life years lost world-wide 2 . With improved survival (in high-income countries 3 ), clearly there is a great need for secondary prevention, such as is offered in cardiac rehabilitation (CR) programs.Many meta-analyses demonstrate that participation in CR is associated with improved quality of life, as well as decreased morbidity and mortality [4][5][6][7] . CR is also cost-effective 8 . Accordingly, it is a class 1 level A recommendation in clinical practice guidelines for CVD patients 9,10 . 19 , have established guidelines to ensure consistent provision and quality of CR delivery in order to achieve the greatest population health benefits. They all outline the nature of patients indicated for services, and make recommendations regarding the composition of a multi-disciplinary...

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Physical Activity and Cardiorespiratory Fitness as Major Markers of Cardiovascular Risk: Their Independent and Interwoven Importance to Health Status

Cited by 579 publications

References 61 publications

Cardiorespiratory Fitness and Incidence of Type 2 Diabetes in United States Veterans on Statin Therapy

Cardiorespiratory Fitness and Incidence of Type 2 Diabetes in United States Veterans on Statin Therapy

Measured cardiorespiratory fitness and self‐reported physical activity: associations with cancer risk and death in a long‐term prospective cohort study

A Review of Cardiac Rehabilitation Delivery Around the World

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