Clinical benefits and exercise prescription in primary cardiovascular prevention
Worldwide the leading causes of morbidity and mortality are diseases whose common denominator the atherosclerotic process, some of which represent the known cardiovascular risk factors such as diabetes mellitus or hypertension, and others are as a result of these ischemic heart disease or stroke. There is now enough scientific evidence that physical exercise is an effective treatment to control cardiovascular risk factors, but its role has not received the necessary importance in primary cardiovascular prevention.
Physical activity is defined as any partial or total bodily movement, which generally has the purpose of covering some need or performing some of the activities of daily life.Physical exercise is defined as a specific type of physical activity, performed in a planned, structured, repetitive and systematic way that aims to improve physical fitness.
Sport is a type of exercise that has pre-established rules and has a competitive background. The three categories lead to an increase in the energy expenditure to be realized and therefore a greater uptake of oxygen.The ability to perform or not to perform a physical activity, physical exercise or sport, will be determined by the level of fitness, which is defined as the proper development of motor skills: aerobic endurance and muscular strength.Aerobic endurance is defined as the ability to carry out stressful stresses to the cardiorespiratory and muscular system over a prolonged or repeated period of time. The level of aerobic endurance is measured by determining the maximum oxygen consumption.
Oxygen consumption is defined as the maximum amount of oxygen that the body is able to provide (at the respiratory level), to transport (at the cardiovascular level) and to use (at the muscular level) when it exerts a physical effort.The oxygen consumption is measured in absolute values in L / min, or when adjusted for the weight of each person in mL / kg / min. At rest, all people consume 3.5 mL / kg / min of oxygen to cover our baseline needs. This amount has therefore been termed a basal metabolic unit or metabolic equivalent (MET).
As we perform activities of greater physical effort, the oxygen consumption in the body increases, until reaching a point in which, despite increasing the intensity of physical effort, the body is no longer able to increase oxygen consumption; at this point the maximum oxygen consumption has been reached, and this can be expressed, as already mentioned, in mL / kg / min or in MET (ie, how many times the organism is able to increase its metabolic rate). Oxygen consumption will depend on factors such as age, gender, health level and level of physical training.
Muscle strength is defined as the ability to overcome an external resistance through a muscle contraction.The maximum strength of a muscle group is determined through a maximal repetition test (1MR), which is denoted as the maximum weight load that a muscle group can mobilize once through the full range of motion Before reaching fatigue.
A sedentary lifestyle has been recognized for almost two decades as an independent cardiovascular risk factor, increasing the risk of coronary heart disease by 1.9 times; however, this risk decreases progressively as the amount of physical activity performed increases and the level of physical condition.
In the diabetic patient, both types of exercise (aerobic and strengthening) have been shown to decrease the percentage values of glycosylated hemoglobin A1c (HbA1c).In hypertensive patients, aerobic endurance exercise and muscle strengthening exercise have been shown to reduce systolic blood pressure and diastolic blood pressure.Patients with dyslipidemia are also benefited by aerobic exercise programs. It is reported an increase in the concentrations of high-density (HDL-C) and statistically significant decreases in triglyceride levels.