2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease
Sports cardiology is an emerging sub-specialty. With the rising prevalence of sedentary lifestyles, obesity and cardiovascular diseases (CVDs), it is crucial to promote regular physical activity to reduce CVD risk. Antonio Pelliccia and the members of the European Society of Cardiology (2020) have come up with a guidelines entitled, “2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease“, to recommend exercises in different types of cardiac problems. Recommendation of exercise ranges from individuals with cardiovascular risk factors to chronic heart failures, valvular heart disease and congenital heart failure. Given the vastness of the paper, this month we will be focusing on summarizing the recommendation for individuals with cardiovascular risk factor and exercise in the elderly.
Objective:
To come up with the first of its kind sports and exercise recommendation on individuals with CVD.
Method:
The guideline was developed from the currently available evidence and scientific and medical knowledge. The selected articles were later classified and graded depending on the usefulness/ efficacy of the procedure and methodology of clinical trials.
Recommended Guidelines:
In Healthy Adults of All Age Group.
European guidelines recommend performing a minimum of 150 min of moderate-intensity endurance exercise training over 5 days or 75 min of vigorous exercise per week over 3 days. Or a gradual increase in aerobic exercise to 300 min/week of moderate-intensity, or 150 min/ week of vigorous-intensity aerobic exercise.
In Individuals with Obesity, Hypertension, Dyslipidemia and Diabetes.
In obese individuals (BMI ≥30 kg/m2 or a waist circumference >80 cm for females or >94 cm for
males), resistance training ≥3 times per week along with moderate or vigorous aerobic exercise (at least 30 min, 5-7 days per week) is recommended to reduce CVD risk.
In individuals with hypertensive, dyslipidemia and diabetes conditions, resistance training ≥3 times per week along with moderate or vigorous aerobic exercise at least 30 min, 5-7 days per week is recommended to reduce blood pressure, maintain blood pressure and lower CVD risk.
In Individuals with Low to Moderate-risk of CVD
Active individuals and individuals at low or moderate risk should not have any restrictions for exercise including competitive sports.
In Individuals with High to Very High-risk of CVD
Sedentary individuals and individuals at high or very high risk may engage in low-intensity exercises without further evaluation. Sedentary individuals and/or those at high or very high-risk planning to undertake moderate to high-intensity exercise with family history and symptoms of CAD should undergo a physical examination, 12-lead ECG, and exercise stress test.
The level of risk was calculated using cardiovascular SCORE risk chart for 10year risk of fatality and presence of co-morbidity.
In Elderly
Adults aged 65 years or older who are fit and have no health conditions that limit their mobility, moderate-intensity aerobic exercise for at least 150 min/week is recommended. In older adults at risk of falls, strength training exercises to improve balance and coordination on at least 2 days a week are recommended.
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