CLINICAL SECTION   

Medicina dello Sport 2001 September;54(3):211-7

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Physical exercise as therapy of chronic coronary heart disease

Notaristefano A., Faleburle M., Notaristefano S.

Unità di Terapia Intensiva Cardiologica, Azienda Ospedaliera di Perugia

Mortality from cardiovascular disease is the first cause of death in the industrialized world and, in this, coronary heart disease has the hightest rate. A sedentary way of life is a risk factor for ischemic heart disease, whereas regular physical activity is a preventative and therapeutic tool. The problem is very important. Only 23.3% of men and 13.2% of women do physical activity at least once a week in Italy. The benefit of regular sporting activity was demonstrated in the fifties, showing that physical exercise done in free time was followed by a reduction in coronary risk. The beneficial effects of training in cases of ischemic chronic cardiopathic are numerous. They lead to an antiatherogenic effect, the diminuition of thrombotic risk, the increase of the ischemic threshold and finally an antiarrhytmic effect. Moreover sporting activity causes a series of central and peripheral adaptions that are responsible for the diminuition of adrenergic tone, the increase of collateral vessels of the coronary circulation and the improvement of the biochemical and metabolic function of the cardiac muscle, with the result of a reduction in the consumption of oxygen and in an increase of peripheral extraction of O2 that lead to an improvement in total working capacity in the ischemic cardiopathic. Therefore the person who suffers coronary heart disease, in addition to conventional therapy (aspirin, beta-blockers, ace-inhibitor, statins), in the absence of counterindication, such as heart failure in action, unstable angina, complex ventricular arrhytmia, acute pericardite, serious hypertension and low ejection fraction, we would recommend a dose of regular isotonic sporting activity, avoiding competitive sports. Therefore physical activity, if well practised and planned, is a safe form of therapy.