Coronary Heart Disease and Exercise: What's the evidence?

Coronary Heart Disease and Exercise: What’s the evidence? Yeong Yeh Lee MD MRCP(UK) MMed May 2009

Exercise & the Heart ,[object Object],[object Object],[object Object],[object Object],[object Object]

HR response to exercise ,[object Object],[object Object],[object Object]

Distribution of CO during Exercise ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Distribution of CO during Exercise termination ,[object Object],[object Object],[object Object],[object Object]

CV response to different type of exercises ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Coronary Heart Disease ,[object Object],[object Object],[object Object]

Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rx ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rx ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rx ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CHD & Exercise ,[object Object],[object Object],[object Object],[object Object]

CHD & Exercise ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CHD & Exercise ,[object Object],[object Object],[object Object]

CHD & Exercise -benefits ,[object Object],[object Object],[object Object],[object Object]

CHD & Exercise – Additional benefits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CHD & Exercise – Additional benefits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PRIMARY PREVENTION ,[object Object],[object Object]

Harvard alumni health study Paffenberger et al. NEJM 1993; 328:538. Sesso et al Circ 2000; 102:975. Lee et al Circ 2000; 102:981 ,[object Object],[object Object],[object Object],[object Object]

Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men . Blair JAMA 1995; 273:1093. ,[object Object],[object Object],[object Object]

Finnish Twin Cohort study Kujala et al. JAMA 1998; 279:440 ,[object Object],[object Object]

Nurses' Health study Manson JE at al NEJM 1999; 341:650. Lee IM et al JAMA 2001; 285:1447 ,[object Object],[object Object],[object Object],[object Object]

American Heart Association (AHA) Circulation 1997; 96:355 ,[object Object],[object Object]

SECONDARY PREVENTION – ,[object Object],[object Object],[object Object],[object Object]

Meta analysis Oldridge et al. Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA 1988; 260:945. ,[object Object],[object Object],[object Object]

National Exercise and Heart Disease Project Circulation 1999; 100:1764 Am J Cardiol 1981; 48:39 ,[object Object],[object Object],[object Object],[object Object]

American Heart Association (AHA) ,[object Object],[object Object]

THE EXERCISE PRESCRIPTION Practical recommendations for exercise programs and for classification of exercise risk, which determine the need for supervision and monitoring, have recently been published

Primary Prevention ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Primary Prevention ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Secondary prevention ,[object Object]

Secondary prevention ,[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object]

Coronary Heart Disease and Exercise: What's the evidence?

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Coronary Heart Disease and Exercise: What's the evidence?