Physical exercise training and coronary artery disease

Coronary artery disease (CAD) is a leading cause of death worldwide, despite improvements in medical and interventional therapies. Based on many studies in large cohorts, regular physical exercise training plays a central and indispensable role in both the primary and secondary prevention of CAD. Exercise training was shown to improve blood pressure control, lipid profile, glucose control, and enhance weight loss in obese patients. Moreover, exercise training not only affects clinical symptoms, it reduces CAD mortality and morbidity in addition to dietary, pharmacological and interventional treatments. Different kinds of exercise training (aerobic, interval, resistance training) have been studied and all are feasible, well tolerated, and beneficial in patients with CAD. Therefore, exercise training has the highest recommendation class (I) and level of evidence (A) in the European guidelines for patients with coronary artery disease. Nonetheless, exercise training is underutilized in patients with cardiac diseases and only a minority of eligible patients is referred to a cardiac rehabilitation or structured exercise training program by their physician.