Physical activity in primary and secondary prevention of cardiovascular disease: Overview updated

Table 1 Summary of the benefits of physical activity in primary prevention

Physical activity in primary prevention
Prevents	Improves
Diseases development associated with cardiovascular disease (hypertension, diabetes and metabolic syndrome)	Physical activity levels and physical fitness (cardiorespiratory fitness and skeletal muscle strength)
Obesity	Prevents weight gains, and improves blood cholesterol profile towards increased HDL blood levels and lower LDL blood levels
Type 2 diabetes	Glycemic control, and improves insulin sensitivity in type 2 diabetics
Hypertension	Prevents the development of hypertension in normotensive individuals, and reduces blood pressure in hypertensive patients
Vascular inflammation and atherosclerosis	Reduces blood concentrations of several inflammatory biomarkers such as C-reactive protein, lipoprotein-associated phospholipase A2, cytokines IL-1β, IL-6 and TNF-α

TNF: Tumor necrosis factor; HDL: High density cholesterol; LDL: Low density cholesterol; IL: Interleukin.

Table 2 Summary of the cardiovascular protection mechanisms induced by physical activity in secondary prevention

Physical activity in secondary prevention
Decreases	Increases
Resting heart rate	Heart rate reserve
Resting systolic blood pressure	Diastolic function
Myocardial oxygen demand	Coronary circulation
Risk of myocardial ischemia	Myocardial perfusion
Sympathetic tone	Parasympathetic activity
Arterial Stiffness	Endothelial function
Low-grade vascular inflammation (levels of pro- inflammatory cytokines)	Nitric oxide bioavailability and circulating levels of endothelial progenitor cells
Expression of reactive oxygen species	Expression and activity of anti-oxidant enzymes
Resting levels of plasminogen activator inhibitor type 1	Resting levels of tissue plasminogen activator activity
Platelet adhesion and aggregation