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To describe the known benefits of regular aerobic exercise and current recommendations for implementation of exercise programs.

Inclusion criteria for articles not described.

Exclusion criteria for articles not described.

Recruitment:  Method of article inclusion not described.

Design:  Consensus Report.

Blinding Used (if applicable):  not applicable

Intervention (if applicable):  not applicable

Statistical Analysis:  Not performed.

Timing of Measurements:  not applicable

Dependent Variables:  not applicable

Independent Variables:  not applicable

Control Variables:  not applicable

Initial N:  107 references included

Attrition (Final N):  107 references

Age:  not applicable

Ethnicity:  not applicable

Other relevant demographics:  not applicable

Anthropometrics:  not applicable

Location:  worldwide studies

Benefits of Exercise

1.  Healthy persons as well as many with CVD including those with CHF can improve exercise performance with training.

• improvement is the result of increased ability to use O^₂ to derive energy for work
• exercise training increases maximum ventilatory O₂ uptake by increasing both maximum cardiac output and the ability of the muscles to extract and use O₂ from the blood.
• beneficial changes in hemodynamic, hormonal, metabolic, neurological, and respiratory function also occur with increased exercise capacity

2.  Exercise training favorably alters lipid and carbohydrate metabolism.

• exercise improves insulin sensitivity
• exercise favorably affects fibrinogen levels
• exercise enhances the benefits of a low SF, low cholesterol diet on blood lipoproteins

3.  Exercise improves psychological functioning by reducing depression and some type A behaviors.

4.  Long-term adherence to exercise programs is problematic with only 50% continuing beyond 6 months after initiating a program.

Implementation of Exercise Programs

1.  Activities at intensities exceeding 40% to 50% of exercise capacity have health benefits when performed regularly.

2.  For health promotion, dynamic exercise of the large muscles for extended periods of time (30 - 60 minutes, 2 - 6 times/week) is recommended.

Medical Professionals

1.  Physicians have the opportunity and responsibility to promote regular physical activity as well as reduction of blood pressure, weight control, management of abnormal blood lipids, and prevention and cessation of smoking.

2.  Persons with known or suspected CVD, respiratory, metabolic, orthopedic, or neurological disorders as well as middle-aged or older sedentary persons with symptoms of CVD should consult their personal physician before beginning or significantly increasing physical activity.

3.  Physicians should assess each patients' physical activity pattern and prescribe and give advice about physical activity.

4.  Medical evaluation + exercise test may be necessary for those with known risk for CVD.

Parents

1.  Parents must know the health benefits of regular physical activity and how exercise contributes to quality of life in order to incorporate activity into their and family members' daily lives.

Schools

1.  Schools must teach the benefits of exercise and the development and maintenance of exercise and exercise conditioning throughout life.

Employers and Community Groups

1.  Communities and employers should develop exercise programs tailored to the needs of persons in the community and workplace.

Additional Research and Future Issues

1.  Data on exercise and its effects on the cardiovascular system and long-term survival are limited.

2.  Research should be conducted to establish the cost-effectiveness of physical activity programs for the enhancement of cardiovascular health, especially the type of promotional strategies required for initiating and maintaining physical activity as well as the social context of such activity.   

Physical inactivity is recognized as a risk factor for CHD and exercise training increases cardiovascular functional capacity and decreases myocardial O₂ demand at any level of physical activity in apparently healthy persons as well as in most subjects with CVD.

Exercise can help control blood lipid abnormalities, diabetes and obesity and aerobic exercise adds an independent blood pressure-lowering effect in certain hypertensive groups with a decrease of 8 to 10 mm Hg in both systolic and diastolic blood pressure measurements.

There is a dose response relation between the amount of exercise performed from ~700 to 2000 kcal of energy expenditure per week and all-cause mortality and CVD mortality in the middle-aged and elderly.

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No description of article inclusion or exclusion or study quality or validity.