It is well known that exercise and nutrition have an important role in disease prevention and management. However, there are still gaps in the literature regarding best exercise prescription practices related to decreasing cardiovascular disease risk. In order to determine specific exercise recommendations, it is necessary to understand some of the most established cardiovascular risk factors and biomarkers. Individuals with obesity, hypertension, dyslipidemia, current smoker status, cardiovascular familial history, poor diet, and a sedentary lifestyle are at highest risk for heart disease (Kannel & McGee, 1979). Articles focused on exercise specific to adipose tissue loss (obesity) and improvements in dyslipidemia, blood pressure, and cardiorespiratory fitness (ie. VO2max, heart rate, perceived exertion, etc.) were used to determine best practices in decreasing overall risk for heart disease.
Aerobic training is an effective form of exercise proven to decrease body fat (Hansen et al., 2018; Schroeder et al., 2019) and improve cardiovascular function (Alex et al., 2013; Goldfield et al., 2015) in both young and elderly individuals. To improve cardiovascular function, it is recommended to focus predominately on aerobic exercise, that works larger muscle groups, for at least 150 minutes per week, and close to 250 minutes per week if the goal is weight loss. While it has been suggested that low intensity, longer duration exercise is needed to utilize and burn fat stores, research is not well established in this area and moderate intensity aerobic exercise is recommended (Hansen et al., 2018). Research focused on exercise specific to fat loss can be difficult to draw conclusions from as methods are typically combined with caloric restriction.
Strength training has also proven to be an effective form of exercise to improve various outcomes such as muscular strength, lean mass, hypertension, waist circumference, and lipid profiles (Kim et al., 2013; Hansen et al., 2018; Goldfield et al., 2015; Schroeder et al., 2019). It is recommended to add dynamic resistance training twice weekly to help improve these outcomes. Resistance training should focus on large muscle group exercises and should be of moderate intensity (50-70% of one rep max). It is best to perform 8-12 reps per set and work up to 3 sets of each movement (Hansen et al., 2018).
Aerobic exercise and strength training are both effective exercise types to help improve risk for cardiovascular disease. In fact, randomized control trials evaluating 3 separate groups (aerobic exercise only, strength training only, and combination training) found that combination training had the most significant improvements in muscular strength, cardiorespiratory fitness, blood pressure, endurance and lean body mass (Goldfield et al., 2015; Schroeder et al., 2019). Based off these conclusions, exercise specific to cardiovascular disease risk should include both a combination of 150-250 minutes of moderate intensity aerobic exercise per week, as well as dynamic resistance training involving large muscle group movements (Hansen et al., 2018).
References
Alex, C., Lindgren, M., Shapiro, P. A., McKinley, P. S., Brondolo, E. N., Myers, M. M., … & Sloan, R. P. (2013). Aerobic exercise and strength training effects on cardiovascular sympathetic function in healthy adults: a randomized controlled trial. Psychosomatic medicine, 75(4), 375.]
Goldfield, G. S., Kenny, G. P., Alberga, A. S., Prud’homme, D., Hadjiyannakis, S., Gougeon, R., … & Wells, G. A. (2015). Effects of aerobic training, resistance training, or both on psychological health in adolescents with obesity: The HEARTY randomized controlled trial. Journal of consulting and clinical psychology, 83(6), 1123.
Hansen, D., Niebauer, J., Cornelissen, V., Barna, O., Neunhäuserer, D., Stettler, C., … & Vanhees, L. (2018). Exercise prescription in patients with different combinations of cardiovascular disease risk factors: a consensus statement from the EXPERT working group. Sports medicine, 48(8), 1781-1797.
Kannel, W. B., & McGee, D. L. (1979). Diabetes and cardiovascular risk factors: the Framingham study. Circulation, 59(1), 8-13.
Kim, H. S., & Kim, D. G. (2013). Effect of long-term resistance exercise on body composition, blood lipid factors, and vascular compliance in the hypertensive elderly men. Journal of exercise rehabilitation, 9(2), 271.
Schroeder, E. C., Franke, W. D., Sharp, R. L., & Lee, D. C. (2019). Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: a randomized controlled trial. PloS one, 14(1), e0210292.
