Exercise for Coronary Heart Disease Patients: Little Is Good, More Is Better, Vigorous Is Best

Furthermore, the PA-associated reductions in mortality were greater among CHD patients, whose exercise was limited by dyspnea and in those with a high STABILITY CHD risk score, suggesting that high-risk patients benefit the most from a physically active lifestyle. Furthermore, it is important to emphasize that patients in the STABILITY trial mainly performed low- to moderate-intensity PA, whereas vigorous-intensity PA is known to transiently increase the risk for sudden cardiac death, especially in previously inactive patients (17). [...]findings from Stewart et al. In the interim, patients and clinicians should remember that a little is good, more is better, and vigorous is best. 1 M.F. Maessen, A.L. Verbeek, E.A. Bakker, P.D. Thompson, M.T. Hopman, T.M. Eijsvogels, Lifelong exercise patterns and cardiovascular health, Mayo Clin Proc, Vol. 91, 2016, 745-754 2 C.P. Wen, J.P. Wai, M.K. Tsai, Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study, Lancet, Vol. 378, 2011, 1244-1253 3 U. Ekelund, J. Steene-Johannessen, W.J. Brown, Lancet, Vol. 388, 2016, 1302-1310 4 Physical Activity Guidelines Advisory Committee. Cochrane systematic review and meta-analysis, J Am Coll Cardiol, Vol. 67, 2016, 1-12 8 R.A.H. Stewart, C. Held, N. Hadziosmanovic, on behalf of the STABILITY Investigators, Physical activity and mortality in patients with stable coronary heart disease, J Am Coll Cardiol, Vol. 70, 2017, 1689-1700 9 S.M. Dyrstad, B.H. Hansen, I.M. Holme, S.A. Anderssen, Comparison of self-reported versus accelerometer-measured physical activity, Med Sci Sport Exer, Vol. 46, 2014, 99-106 10 T.M. Eijsvogels, S. Molossi, D.C. Lee, M.S. Emery, P.D. Thompson, Exercise at the extremes: the amount of exercise to reduce cardiovascular events, J Am Coll Cardiol, Vol. 67, 2016, 316-329 11 H. Arem, S.C. Moore, A. Patel, Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship, JAMA Intern Med, Vol. 175, 2015, 959-967 12 R.S. Paffenbarger Jr., R.T. Hyde, A.L. Wing, C.C. Hsieh, Physical activity, all-cause mortality, and longevity of college alumni, N Engl J Med, Vol. 314, 1986, 605-613 13 T. Moholdt, U. Wisloff, T.I. Nilsen, S.A. Slordahl, Physical activity and mortality in men and women with coronary heart disease: a prospective population-based cohort study in Norway (the HUNT study), Eur J Cardiovasc Prev Rehabil, Vol. 15, 2008, 639-645 14 P.T. Williams, P.D. Thompson,