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Reducing health risks of physical inactivity by cardiac rehabilitation

Nature Reviews Cardiology volume 9, page 733 (2012)Cite this article

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In her Research Highlight (King, A. Public health: Health risks of physical inactivity similar to smoking. Nat. Rev. Cardiol. 9, 492 [2012]),1 Alexandra King refers to the impact of health risks related to physical inactivity. Lack of physical exercise accounts for approximately 1 in 10 deaths annually, and up to 10% of noncontagious diseases such as type 2 diabetes mellitus, coronary heart disease, and breast or colon cancer.2 Physical inactivity is a risk factor for many diseases. However, even a formerly inactive patient who has been diagnosed with a disease such as chronic heart failure (CHF) can substantially benefit from becoming physically active, which is of particular relevance for cardiac rehabilitation. As a physician in a rehabilitation hospital, I regularly see patients who used to be physically inactive making their first steps towards lifestyle changes such as engaging in physical exercise during hospitalization.

Both the Research Highlight by King1 and studies published in the medical literature have important practical implications for cardiac rehabilitation. For example, a prospective cohort study involving healthy participants in Taiwan demonstrated that even a small amount of regular exercise (92 min per week) led to a significant increase in life expectancy.3 In addition, evidence exists that supervised exercise results in better outcomes than primary stenting in patients with peripheral artery disease.4 This finding supports an association between exercise and improved vascular endothelial function owing to reduced intima–media thickness.5 Anabolic effects and improved muscular function have been demonstrated with exercise in patients with advanced CHF.6 Additional evidence stems from an exercise-related reduction of E3 ubiquitin-protein ligase TRIM63 (also known as MuRF-1) in the setting of CHF.7 MuRF-1 contributes to proteolysis in muscle wasting,7 to which patients with CHF are particularly vulnerable. Evidence also exists that exercises incorporating balance and strength training lead to a significant reduction in the number of falls among healthy elderly people (aged ≥70 years).8 Balance and strength training will also prevent muscular atrophy, osteoporosis fractures, and secondary illness owing to inactivity after a fall.

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References

  1. King, A. Public health: Health risks of physical inactivity similar to smoking. Nat. Rev. Cardiol. 9, 492 (2012).

    Article  Google Scholar 

  2. Lee, I. M. et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 380, 219–229 (2012).

    Article  Google Scholar 

  3. Wen, C. P. et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet 378, 1244–1253 (2011).

    Article  Google Scholar 

  4. Murphy, T. P. et al. Supervised exercise versus primary stenting for claudication resulting from aortoiliac peripheral artery disease: six-month outcomes from the claudication: exercise versus endoluminal revascularization (CLEVER) study. Circulation 125, 130–139 (2012).

    Article  Google Scholar 

  5. Pahkala, K. et al. Association of physical activity with vascular endothelial function and intima–media thickness. Circulation 124, 1956–1963 (2011).

    Article  Google Scholar 

  6. Höllriegel, R. et al. Anabolic effects of exercise training in patients with advanced chronic heart failure (NYHA IIIb): impact on ubiquitin–protein ligases expression and skeletal muscle size. Int. J. Cardiol. http://dx.doi.org/10.1016/j.ijcard.2012.03.083.

  7. Gielen, S. et al. Exercise training attenuates MuRF-1 expression in the skeletal muscle of patients with chronic heart failure independent of age: the randomized Leipzig Exercise Intervention in Chronic Heart Failure and Aging catabolism study. Circulation 125, 2716–2727 (2012).

    Article  CAS  Google Scholar 

  8. Clemson, L. et al. Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ 345, e4547 (2012).

    Article  Google Scholar 

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  1. Klinik Adelheid Rehabilitation Hospital, Internal Medicine Ward, Höhenweg 71, Unterägeri, 6314, Switzerland

    Rainer Spiegel

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  1. Rainer Spiegel
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Spiegel, R. Reducing health risks of physical inactivity by cardiac rehabilitation. Nat Rev Cardiol 9, 733 (2012). https://doi.org/10.1038/nrcardio.2012.115-c1

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