Published online Apr 26, 2018. doi: 10.4330/wjc.v10.i4.26
Peer-review started: January 18, 2018
First decision: January 31, 2018
Revised: March 15, 2018
Accepted: April 1, 2018
Article in press: April 1, 2018
Published online: April 26, 2018
Cardiovascular diseases (CVDs) remain the main cause of death in the world with about 17.5 million deaths. CVDs are usually associated with a high level of risk factors. The practice of physical activity has benefits on the risk factors, however, we do not know the preventive action of physical fitness on the risk factors in patients who have developed CVDs. Thus, this study aims to quantify the preventive fraction of physical fitness on the risk factors in patients with CVDs.
The effect of physical fitness on the risk factors in patients who have developed a cardiovascular disease remains an open question. Regular physical activity is a practice accessible to all patients with CVDs, but it may be difficult to adhere to an aerobic-based exercise program, due to external constraints.
Quantifying the preventive fraction of physical fitness on the risk factors in patients with CVDs is very important. The aggregate role of physical fitness in the development of cardiovascular risk factors needs to be better documented. Our work provides new insights on this research field.
A total of 249 subjects (205 men and 44 women) suffering from a CVD were categorized into four groups, according to their percentage of physical fitness. The physical fitness of subjects was evaluated from an exercise stress test on an ergocycle. We calculated the odds ratio to obtain the preventive fraction in order to evaluate the impact of the physical fitness level on the risk factors (i.e., abdominal obesity, depression, diabetes, dyslipidemia, hypertension, obesity, overweight and smoking). The preventive fraction is a ratio used in epidemiological studies to assess the impact of an exposure factor (physical fitness) on a disease (risk factors). It is an important evaluation tool that allows knowing the preventive action of the physical fitness levels on the risk factors studied.
It is observed that a normal physical fitness level is sufficient to induce a preventive action on abdominal obesity (38%), diabetes (12%), hypertension (33%), obesity (12%) and overweight (11%). Also, the preventive fraction increases with the level of physical fitness, in particular for hypertension (36%) and overweight (16%). A high physical fitness level does not necessarily induce a preventive action in most risk factors, excluding depression. Our study suggests that even if the recommendations of ACSM (allowing to reach 100% of the theoretical physical fitness) are not met, a normal physical fitness level, even 20% below the predicted fitness, is enough to reduce some of the risk factors studied.
This study demonstrates that a normal physical fitness level induces a preventive action for most risk factors studied. A high level of physical fitness does not necessarily lead to a better preventive fraction. CVDs remain the main cause of death in the world with about 17.5 million deaths. It is observed that almost half of the deaths in Europe are attributable to CVDs, touching approximately 1.9 million men and 2.2 million women. The development of different risk factors (i.e., abdominal obesity, depression, diabetes, dyslipidemia, hypertension, obesity, overweight, smoking) and physical inactivity promote CVDs. The practice of physical activities allows to decrease the risk of CVDs and has a protective role against metabolic risk factors.
There is evidence of an inverse relationship between the physical activity and CVDs; our study reinforces these statements. However, it may be difficult to adhere to an aerobic-based exercise program, due to external constraints. Our study suggests that a normal physical fitness level, even 20% below the predicted fitness, is enough to reduce some of the risk factors studied. The practice of physical activity should be maintained throughout life to preserve these training effects. The future research should include the pharmacological treatments.