Contemporary Approaches to Prescribing Exercise in Coronary Artery Disease Patients

Overview

Journal Am J Lifestyle Med

Publisher Sage Publications

Date 2018 Sep 12

PMID 30202385

Citations 5

Authors

Peter H Brubaker

James H Ross

Kee Chan Joo

Affiliations

Soon will be listed here.

Abstract

Health care professionals engaged in the management of coronary artery disease (CAD) patients, both in primary and secondary prevention settings, should possess the knowledge to develop and modify both aerobic exercise as well as musculoskeletal resistance exercise training programs. The traditional exercise prescription (ExRx) for aerobic-type exercise describes the intensity, frequency, duration, and mode of exercise, as well as the rate of progression. The more contemporary ExRx focuses on the energy expenditure associated with all physical activity not just structured exercise bouts. The total "volume or dose" of physical activity is associated with important health outcomes, including the potential to prevent and potentially reverse CAD lesions. Also, emerging evidence supporting the use of high-intensity interval training in CAD patients will also be provided. Furthermore, this review will also address the issue of generating an appropriate ExRx in the absence of maximal exercise "stress" test data, a common occurrence in the primary care setting and in this era of health care cost containment. Prescribing resistance exercise for CAD patients requires careful consideration and will be discussed in this review. Finally, this review will conclude with a section that describes the special considerations and/or modifications for some common comorbidities seen in CAD patients.

Citing Articles

Pericoronary fat attenuation index-a new imaging biomarker and its diagnostic and prognostic utility: a systematic review and meta-analysis.

Sagris M, Antonopoulos A, Simantiris S, Oikonomou E, Siasos G, Tsioufis K Eur Heart J Cardiovasc Imaging. 2022; 23(12):e526-e536.

PMID: 36069510 PMC: 9840478. DOI: 10.1093/ehjci/jeac174.

Exercise Training and Interventions for Coronary Artery Disease.

Fernandez-Rubio H, Becerro-de-Bengoa-Vallejo R, Rodriguez-Sanz D, Calvo-Lobo C, Vicente-Campos D, Chicharro J J Cardiovasc Dev Dis. 2022; 9(5).

PMID: 35621842 PMC: 9146277. DOI: 10.3390/jcdd9050131.

Agreement between heart rate at first ventilatory threshold on treadmill and at 6-min walk test in coronary artery disease patients on β-blockers treatment.

Calegari L, Moreira I, Falkowski A, Reolao J, Karsten M, Fernando Deresz L J Exerc Rehabil. 2021; 17(5):362-368.

PMID: 34805026 PMC: 8566104. DOI: 10.12965/jer.2142488.244.

Awareness of Warning Symptoms of Heart Disease and Stroke: Results of a Follow-up Study of the Chinese Canadian Cardiovascular Health Project.

Lee C, Chow C, Yan A, Moe G, Tu J, Chu J CJC Open. 2021; 3(6):741-750.

PMID: 34169253 PMC: 8209403. DOI: 10.1016/j.cjco.2021.01.014.

Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association.

Hayes S, Kim E, Saw J, Adlam D, Arslanian-Engoren C, Economy K Circulation. 2018; 137(19):e523-e557.

PMID: 29472380 PMC: 5957087. DOI: 10.1161/CIR.0000000000000564.

References

Brawner C, Ehrman J, Schairer J, Cao J, Keteyian S . Predicting maximum heart rate among patients with coronary heart disease receiving beta-adrenergic blockade therapy. Am Heart J. 2004; 148(5):910-4. DOI: 10.1016/j.ahj.2004.04.035. View

Schairer J, Kostelnik T, Proffitt S, Faitel K, Windeler S, Rickman L . Caloric expenditure during cardiac rehabilitation. J Cardiopulm Rehabil. 1998; 18(4):290-4. DOI: 10.1097/00008483-199807000-00006. View

Leon A, Franklin B, Costa F, Balady G, Berra K, Stewart K . Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council.... Circulation. 2005; 111(3):369-76. DOI: 10.1161/01.CIR.0000151788.08740.5C. View

Almeida S, Williams K, Shaffer R, Brodine S . Epidemiological patterns of musculoskeletal injuries and physical training. Med Sci Sports Exerc. 1999; 31(8):1176-82. DOI: 10.1097/00005768-199908000-00015. View

Brawner C, Vanzant M, Ehrman J, Foster C, Porcari J, Kelso A . Guiding exercise using the talk test among patients with coronary artery disease. J Cardiopulm Rehabil. 2006; 26(2):72-5. DOI: 10.1097/00008483-200603000-00002. View

. Standards of medical care in diabetes--2007. Diabetes Care. 2006; 30 Suppl 1:S4-S41. DOI: 10.2337/dc07-S004. View

Savage P, Brochu M, Scott P, Ades P . Low caloric expenditure in cardiac rehabilitation. Am Heart J. 2000; 140(3):527-33. DOI: 10.1067/mhj.2000.109219. View

Romero-Corral A, Montori V, Somers V, Korinek J, Thomas R, Allison T . Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006; 368(9536):666-78. DOI: 10.1016/S0140-6736(06)69251-9. View

Jakicic J, Marcus B, Gallagher K, Napolitano M, Lang W . Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA. 2003; 290(10):1323-30. DOI: 10.1001/jama.290.10.1323. View

10.

Dishman R . Prescribing exercise intensity for healthy adults using perceived exertion. Med Sci Sports Exerc. 1994; 26(9):1087-94. View

11.

Go A, Mozaffarian D, Roger V, Benjamin E, Berry J, Blaha M . Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2013; 129(3):e28-e292. PMC: 5408159. DOI: 10.1161/01.cir.0000441139.02102.80. View

12.

Woolf-May K, Bird S . Physical activity levels during phase IV cardiac rehabilitation in a group of male myocardial infarction patients. Br J Sports Med. 2005; 39(3):e12. PMC: 1725153. DOI: 10.1136/bjsm.2003.010983. View

13.

Mezzani A, Hamm L, Jones A, McBride P, Moholdt T, Stone J . Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary.... J Cardiopulm Rehabil Prev. 2012; 32(6):327-50. DOI: 10.1097/HCR.0b013e3182757050. View

14.

Schneider P, Bassett Jr D, Thompson D, Pronk N, Bielak K . Effects of a 10,000 steps per day goal in overweight adults. Am J Health Promot. 2006; 21(2):85-9. DOI: 10.4278/0890-1171-21.2.85. View

15.

Pescatello L, Franklin B, Fagard R, Farquhar W, Kelley G, Ray C . American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004; 36(3):533-53. DOI: 10.1249/01.mss.0000115224.88514.3a. View

16.

Sigal R, Kenny G, Wasserman D, Castaneda-Sceppa C, White R . Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006; 29(6):1433-8. DOI: 10.2337/dc06-9910. View

17.

Borg G . Perceived exertion: a note on "history" and methods. Med Sci Sports. 1973; 5(2):90-3. View

18.

Swain D, Leutholtz B . Heart rate reserve is equivalent to %VO2 reserve, not to %VO2max. Med Sci Sports Exerc. 1997; 29(3):410-4. DOI: 10.1097/00005768-199703000-00018. View

19.

Verrill D, Ribisl P . Resistive exercise training in cardiac rehabilitation. An update. Sports Med. 1996; 21(5):347-83. DOI: 10.2165/00007256-199621050-00004. View

20.

Joo K, Brubaker P, MacDougall A, Saikin A, Ross J, Whaley M . Exercise prescription using resting heart rate plus 20 or perceived exertion in cardiac rehabilitation. J Cardiopulm Rehabil. 2004; 24(3):178-84. DOI: 10.1097/00008483-200405000-00008. View