Exercise and the Heart in Health and Disease [antikvár]

Preface The last few years have seen an ever-growing interest in exercise as a means to health, partictdarly cardiac health, with enthusiastic participation not only by clinically healthy individuals of all ages, but also by patients with various types of cardiac disorders. Patients have even completed marathon runs after both myocardial iiifarction and cardiac transplant operations. Surprisingly, the scientific evidence supporting adoption of an active lifestyle remains relatively incomplete. Secondary rehabilitation (the promotion of exercise for the clinically healthy middle-aged adult who undoubtedly has some occult atherosclerotic lesions of the coronary vessels) is based not on direct experiment, but rather on a number of epidemiological studies, the majority of which have demonstrated a low incidence of myocardial infarction in populations presumed to be physically active. Tertiary rehabilitation (the cardiac rehabilitation programs offered after myocardial infarction) has been tested by prospective experiments in which patients have been randomly assigned to either exercise or control groups, but again, individual studies of 300-700 patients have not been large enough to demonstrate a statistically significant improvement of prognosis in the exercised group. Recourse has been made to a pooling of data (the somewhat dubious approach of metanalysis) to show a relatively uniform 20-30 percent decrease of mortality in exercised patients.