# Exercise as it relates to Disease/Physical Activity; An effective intervention for cardiovascular disease
### What is cardiovascular disease?

The term cardiovascular disease refers to any disease/condition that has an association with the heart or the blood vessels in the human body. Cardiovascular diseases are an international health burden, being the leading cause of morbidity and premature mortality in most western cultures and has been identified by the World Health Organisation (WHO) as the number one global health issue. Cardiovascular diseases include: Coronary Artery Disease, Stroke and Myocardial Infarction (Heart Attack).

### Prevalence

* Cardiovascular disease effects 1 in 6 Australians, equating to 3.7 million people within our population.
* In 2011, Cardiovascular diseases were the leading cause of death in Australia with 45,600 deaths reported.
* In 2004 - 2005, $6 billion of all health care expenditure was focused upon cardiovascular disease in Australia.

## Cardiovascular Disease Risk Factors

| Modifiable Risk Factors | Non-Modifiable Risk Factors |
| High Blood Pressure | Increasing Age |
| High Blood Cholesterol | Family History of Cardiovascular Disease |
| Diabetes Mellitus (Type 2 Diabetes) | Gender |
| Physical Inactivity | |
| Overweight/Obese & High levels of Adiposity | |
| Tobacco Smoking | |

## The Implementation of Physical Activity as a Primary Prevention Strategy

The primary prevention of cardiovascular diseases is a global health concern. An increase in chronic disease prevalence and a steadily ageing Australian population, has resulted in a growing cardiovascular disease burden. However; the majority of risk factors associated with cardiovascular disease are modifiable lifestyle factors and therefore have the potential to be amended by physical activity, reducing both the overall risk factors for individuals and consequently mortality rates.

## Exercise Recommendations to reduce Cardiovascular Disease Risk
### Aerobic Exercise

In regards to aerobic exercise, it is recommended that individuals undertake 30–60 minutes/day of moderate exercise five to seven times a week. Multiple research studies have highlighted the importance of intensity, rather than duration of the exercise to reduce the cardiovascular risks. Long duration bouts of aerobic exercise predominately benefit weight/adiposity reduction, while intensity has been postulated to have more positive effects on specific cardiac function. Vigorous Activity may also be implemented three to four times a week, for a duration of 30 minutes for the individual to achieve further protection and reduction of cardiovascular risk factors.

### Resistance Exercise

In conjunction with aerobic exercise, it is recommended that resistance exercise should be completed 2-3 times/week. The resistance exercise undertaken should involve the bodies large muscle groups of both the upper and lower extremities, as well as the core and the intensity should be 30-60% of the individuals 1RM for 12 repetitions.

## Benefits of Physical Activity on Cardiovascular Health

Exercise, especially aerobic, induces many favourable effects on cardiovascular risk factors, therefore reducing the prevalence of the disease occurring.
| Cardiovascular Benefits from Aerobic Exercise | Cardiovascular Benefits from Resistance Exercise |
| ↑ insulin sensitivity & glucose tolerance | ↑ insulin sensitivity & glucose tolerance |
| ↓ Blood Pressure | Maintain lean skeletal body mass |
| ↓ Weight & Adiposity levels | Decrease insomnia & depression |
| ↑ Cholesterol profile, ↓ Triglyceride's & ↑ HDL | |
| Enhance endothelial function | |
Note: ↑: Increased & ↓: Decreased The culmination of the above benefits, reduce the chance of cardiovascular risk factors such as diabetes mellitus, high blood cholesterol levels, high blood pressure and high levels of adiposity will occur in the individual.

## Further reading

* The National Heart Foundation of Australia
* Australian Institute of Health & Welfare - Cardiovascular Health
* Baker IDI - Heart & Diabetes Institute
* National Physical Activity Guidelines for Australia

## References

* 1 2 3 4 Australian Institute of Health & Welfare, 'Cardiovascular Health', viewed 22nd of October, http://www.aihw.gov.au/cardiovascular-health/
* 1 2 Baker IDI: Heart & Diabetes Institute, 'Preventative Health Brochures', viewed 22nd of October, http://www.bakeridi.edu.au/preventative_health_brochures/
* 1 2 3 4 5 6 7 8 9 Payne, R.A. (2012) Cardiovascular risk. British Journal of Clinical Pharmacology, 74:3, 396-410
* 1 2 3 4 5 6 7 8 9 10 11 12 Chen,Z.U., Huang,Y., Laher,I., Leung,F.P., Yoa, X., & Yung, L.M (2008) Exercise, vascular wall & cardiovascular diseases. An update (Part 1). Sports Med, 38(12): 1009-1024
* ↑ National Heart Foundation of Australia, 'Data & Statistics', viewed 22nd of October, http://www.heartfoundation.org.au/information-for-professionals/data-and-statistics/Pages/default.aspx
* 1 2 McCann,L.R & O'Reilly,S.L. (2012) Development & validation of the diet quality tool for use in cardiovascular disease prevention settings. Australian Journal of Primary Health, 18, 138-147
* 1 2 3 4 5 6 Chen,Z.U., Huang,Y., Laher,I., Leung,F.P., Yoa, X., & Yung, L.M (2009) Exercise, vascular wall & cardiovascular diseases. An update (Part 2). Sports Med, 39(1): 45 - 63
* 1 2 Commonwealth of Australia. (1999) National Physical Activity Guidelines for Australia. http://www.heartfoundation.org.au/information-for-professionals/australian-physical-activity-network/Pages/guides-and-policies.aspx
* 1 2 3 4 5 6 7 8 9 10 11 12 13 Perez-Terzic,C.M. (2012)Exercise in cardiovascular diseases. American Academy of Physical Medicine & Rehabilitation, 4, 867-873
* 1 2 3 4 Barclay, G., & Shiraev, T. (2012) Evidence based exercise: Clinical benefits of high intensity interval training. Australian Family Physician, 4:12, 960-962
* 1 2 3 4 5 6 7 From, S., Liira, H., Leppavouri, J., Remes-Lyly, T., Tikkanen, H., & Pitkala, K. (2013) Effectiveness of exercise intervention & health promotion on cardiovascular risk factors in middle aged men: a protocol of a randomised control trial. BMC Public Health,, 13:25, 1-5