International Journal of Cardiology vol:170 issue:3 pages:350-357
Background: Physical activity (PA), physical fitness (PF), and even a few sedentary behaviors (SB) are strongly
and independently linked to improved survival rate. However, key questions remain: what are the physiological
interrelationships between SB, PA, and PF? How should we differently emphasize promoting PA, increasing PF
with exercise, and decreasing SB among other prevention measures? What are the interrelationships of both
PA and SB levels with drug treatment efficacy?
Methods: To address these questions we developed an integrated patient-centric model combining physiology
with epidemiological evidence to characterize the individual risk attached to PA level, PF, and SB. Epidemiological
data were collected by extensive literature review.
Results: Nine meta-analyses, 198 cohort studies (3.8 million people), and 13 controlled trials were reviewed.
1. A high level of SB induces chronic stress and increases the risk of both chronic disease and mortality.
2. Vigorous PA increases PF and physiological reserve, thereby improving survival rate. This effect is notmediated by improved
traditional risk factors.
The risk for most individuals is a mix of high SB, low to mild PA, and low to mild PF.
This model can improve the individualized prescription of PA modalities. Furthermore, the benefit of treatments
such as statins or beta-blockers can be cancelled out if a decrease in PA or an increase in SB is induced by drug
related side effects.
Conclusions: To improve patient management both types of therapeutic interventions and dose should be carefully
chosen for each individual in order to maintain/increase PA level while decreasing SB.