Physical inactivity represents a major cardiovascular risk factor of particular importance in Western industrialized countries, where automation and other technologies have contributed to a continuous decrease in physical activity at work and at home. Although there are various forms of physical exercise, in the context of cardiovascular health the authors are almost exclusively concerned with long-term endurance exercise. Meta-analysis of prospective studies has shown an at least twofold increase in coronary risk in sedentary compared to active, initially healthy subjects, as well as in patients with manifest coronary heart disease (CHD).<sup>3 Berlin J.A., Colditz G.A. A meta-analysis of physical activity in the prevention of coronary heart disease Am J Epidemiol 1990 ;  132 : 612-628

Cliccare qui per andare alla sezione Riferimenti</sup> Conversely, physical activity during leisure time, mainly aerobic endurance exercise, is an effective way to reduce cardiovascular morbidity and mortality, and total mortality; to reduce symptoms in patients with angina, and to improve exercise tolerance, functional capacity, psychological well-being, and quality of life.<sup>43 NIH Consensus Development Panel on Physical Activity and Cardiovascular Health Physical activity and cardiovascular health JAMA 1996 ;  276 : 241-246

Cliccare qui per andare alla sezione Riferimenti</sup> The true impact of regular physical activity on these end points most probably is underestimated. From a public health perspective, engagement in physical exertion represents a cost-effective way to improve cardiovascular health in the general population.

The health benefit conferred by regular aerobic exercise may be mediated in several ways. It has been found to be associated with lower smoking rates, lower body weight, lower cholesterol levels, higher high-density lipoprotein (HDL) cholesterol levels, lower pulse and blood pressure, and other positive physiologic effects, including an improvement in the balance of the hemostatic system by reducing thrombogenic factors and increasing the fibrinolytic capacity.<sup>8 Curfman G.D. The health benefits of exercise N Engl J Med 1993 ;  328 : 574-576  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 35 LaMonte M.J., Eisenman P.A., Adams T.D. , e al. Cardiorespiratory fitness and coronary heart disease risk factors: The LDS hospital fitness institute cohort Circulation 2000 ;  102 : 1623-1628

Cliccare qui per andare alla sezione Riferimenti</sup>