Determination of Cardiovascular Risk and Exercise Recommendations in a Group of Adults and Older Adults
DOI:
https://doi.org/10.18041/2390-0512/biociencias.2.10697Keywords:
cardiovascular disease, exercise, physical activity, risk, American Heart AssociationAbstract
Introduction: the classification of cardiovascular risk allows the appropriate selection of exercise, through individualized assessments, and the generation of recommendations based on evidence. This study determined cardiovascular risk in a group of adults and older adults, using the stratification tool for exercise prescription of the American Heart Association (AHA), pointing out its recommendations, and those of the European Society of Cardiology (ESC). Methods: cross-sectional study, based on surveys of individuals belonging to a physical conditioning program. Cardiovascular risk was determined, a univariate and bivariate analysis was performed. Based on the results, appropriate exercise recommendations were described according to the AHA and the ESC, taking into account additional characteristics such as type and intensity, review mode. Results: the population was 62 participants, 84% (n=52) were women. The mean age was 65.73 ± 10.5 years. 51.6% were older adults (≥ 65 years). 45.2% had a history of hypertension and overweight, followed by diabetes (41.9%), dyslipidemia (33.9%) and valvular disease (21%). The calculated cardiovascular risk was: Latent or Class A: 25.8% (n=16); Low or Class B: 29.0% (n=18); Moderate to High or Class C: 19.4% (n=12), and High or Class D: 25.8% (n=16). There was a higher prevalence of hypertensive patients (39.3%) in class D (p = 0.016). Conclusion: the application of the cardiovascular risk classification strategy emerges as a key element to support informed decision making, generate substantial health benefits, and reduce the risk of complications.
Downloads
References
World Health Organization. Global status report on noncommunicable diseases 2021 [Internet]. Geneva: World Health Organization; 2021 [citado el 18 de marzo de 2024]. Disponible en: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1659-1724. Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31679-8/fulltext
Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, Coke LA, Fleg JL, Forman DE, Gerber TC, Gulati M, Madan K, Rhodes J, Thompson PD, Williams MA. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation. 2013 Aug 20;128(8):873-934. Disponible en: https://doi.org/10.1161/CIR.0b013e31829b5b44.
Aristizábal Rivera JC, Jaramillo Londoño HN, Rico Sierra M. Pautas generales para la prescripción de la actividad física en pacientes con enfermedades cardiovasculares. Iatreia. 2003 Mar 9;16(3):240-253. Disponible en: https://revistas.udea.edu.co/index.php/iatreia/article/view/4006
Jaramillo Gómez NI, Torres de Galvis Y. Aspectos epidemiológicos de la enfermedad cardiovascular: factores de riesgo a la luz de Framingham. CES Med. 2009 Jul 2;18(2):45-68. Disponible en: https://revistas.ces.edu.co/index.php/medicina/article/view/478
Beltrán Castro M, Mateus Alba L. Selección e implementación de actividades físicas basadas en la clasificación de riesgo cardiovascular de la Asociación Americana del Corazón en un grupo de pacientes adultos de Barbosa-Santander en el año 2020 [tesis de postgrado]. Barbosa-Santander: Universidad Cooperativa de Colombia; 2020. Disponible en: https://repository.ucc.edu.co/handle/20.500.12494/20110
Rondanelli IR, Rondanelli SR. Prevención cardiovascular en el adulto mayor. Rev Med Clin Las Condes. 2012;23(6):724-731. Disponible en: https://doi.org/10.1016/s0716-8640(12)70374-7
Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D, Heidbuchel H, Myers J, Niebauer J, Papadakis M, Piepoli MF, Prescott E, Roos-Hesselink JW, Stuart AG, Taylor RS, Thompson PD, Tiberi M, Vanhees L, Wilhelm M; ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease: The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC). Eur Heart J. 2021 Jan 1;42(1):17-96. Disponible en: https://doi.org/10.1093/eurheartj/ehaa605
Mora S, Cook N, Buring JE, Ridker PM, Lee IM. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation. 2007;116:2110–2118. Disponible en: https://www.ahajournals.org/doi/10.1161/circulationaha.107.729939
Van Dam RM, Li T, Spiegelman D, Franco OH, Hu FB. Combined impact of lifestyle factors on mortality: prospective cohort study in US women. BMJ. 2008;337:a1440. Disponible en: https://doi.org/10.1136/bmj.a1440
Smith TC, Wingard DL, Smith B, Kritz-Silverstein D, Barrett-Connor E. Walking decreased risk of cardiovascular disease mortality in older adults with diabetes. J Clin Epidemiol. 2007;60:309–317. Disponible en: https://www.jclinepi.com/article/S0895-4356(06)00256-3/fulltext
Stamatakis E, Hamer M, Lawlor DA. Physical activity, mortality, and cardiovascular disease: is domestic physical activity beneficial? The Scottish Health Survey—1995, 1998, and 2003. Am J Epidemiol. 2009;169:1191–1200. Disponible en: https://doi.org/10.1093/aje/kwp042
Lee IM, Sesso HD, Paffenbarger RS Jr. Physical activity and coronary heart disease risk in men: does the duration of exercise episodes predict risk? Circulation. 2000;102:981–986. Disponible en: https://www.ahajournals.org/doi/full/10.1161/01.CIR.102.9.981
LaCroix AZ, Leveille SG, Hecht JA, Grothaus LC, Wagner EH. ¿Caminar reduce el riesgo de hospitalizaciones por enfermedades cardiovasculares y muerte en adultos mayores? J Am Geriatr Soc. 1996;44:113–120. Disponible en: https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.1996.tb02425.x
Sánchez-González JL, Calvo-Arenillas JI, Sánchez-Rodríguez JL. The effects of moderate physical exercise on cognition in adults over 60 years of age. Rev Neurol. 2018 Apr 1;66(7):230-236. Disponible en: https://neurologia.com/articulo/2017449/eng
Belmonte Darraz S, González-Roldán AM, de María Arrebola J, Montoro-Aguilar CI. Impacto del ejercicio físico en variables relacionadas con el bienestar emocional y funcional en adultos mayores. Rev Esp Geriatr Gerontol. 2021 May-Jun;56(3):136-143. Disponible en: https://www.elsevier.es/es-revista-revista-espanola-geriatria-gerontologia-124-articulo-impacto-del-ejercicio-fisico-variables-S0211139X21000275
Fiuza-Luces C, Santos-Lozano A, Joyner M, Carrera-Bastos P, Picazo O, Zugaza JL, Izquierdo M, Ruilope LM, Lucia A. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nat Rev Cardiol. 2018 Dec;15(12):731-743. Disponible en: https://www.nature.com/articles/s41569-018-0065-1
Katzmarzyk PT, Lee IM, Martin CK, Blair SN. Epidemiology of physical activity and exercise training in the United States. Prog Cardiovasc Dis. 2017 Jan-Feb;60(1):3-10. Disponible en: https://doi.org/10.1016/j.pcad.2017.01.004
Wen H, Wang L. Reducing effect of aerobic exercise on blood pressure of essential hypertensive patients: a meta-analysis. Medicine (Baltimore). 2017;96:e6150. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369884/
Yumuk V, Tsigos C, Fried M, Schindler K, Busetto L, Micic D, Toplak H. European Guidelines for obesity management in adults. Obes Facts. 2015;8:402–424. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644856/
You T, Arsenis NC, Disanzo BL, Lamonte MJ. Effects of exercise training on chronic inflammation in obesity: current evidence and potential mechanisms. Sports Med. 2013;43:243–256. Disponible en: https://europepmc.org/article/med/23494259
Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2006;CD002968. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8989410/
Zhang X, Devlin HM, Smith B, Imperatore G, Thomas W, Lobelo F, Ali MK, Norris K, Gruss S, Bardenheier B, Cho P, Garcia de Quevedo I, Mudaliar U, Jones CD, Durthaler JM, Saaddine J, Geiss LS, Gregg EW. Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: a systematic review and meta-analysis. PLoS One. 2017;12:e0176436. Disponible en: https://europepmc.org/article/med/28493887
Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, Federici M, Filippatos G, Grobbee DE, Hansen TB, Huikuri HV, Johansson I, Juni P, Lettino M, Marx N, Mellbin LG, Ostgren CJ, Rocca B, Roffi M, Sattar N, Seferovic PM, SousaUva M, Valensi P, Wheeler DC. 2019 ESC Guidelines on diabetes, prediabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41:255–323. Disponible en: https://academic.oup.com/eurheartj/article/41/2/255/5556890?login=false
Meseguer Zafra M, Rosa Guillamón A, García-Cantó E, Rodríguez García PL, Pérez-Soto JJ, Tárraga López PJ, Del Moral García JE, Tárraga Marcos ML. Influencia de un programa de ejercicio físico terapéutico en diferentes indicadores clínicos relacionados con la dislipidemia en sujetos adultos de 26 a 73 años con algún factor de riesgo cardiovascular. Hipertens Riesgo Vasc. 2019 Jan-Mar;36(1):21-27. Disponible en: https://doi.org/10.1016/j.hipert.2018.02.001
Kraus WE, Houmard JA, Duscha BD, Knetzger KJ, Wharton MB, McCartney JS, Bales CW, Henes S, Samsa GP, Otvos JD, Kulkarni KR, Slentz CA. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med. 2002;347:1483–1492. Disponible en: https://www.nejm.org/doi/10.1056/NEJMoa020194?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200www.ncbi.nlm.nih.gov
Vanhees L, Geladas N, Hansen D, Kouidi E, Niebauer J, Reiner Z, Cornelissen V, Adamopoulos S, Prescott E, Borjesson M, Bjarnason-Wehrens B, Bjornstad HH, Cohen-Solal A, Conraads V, Corrado D, De Sutter J, Doherty P, Doyle F, Dugmore D, Ellingsen O, Fagard R, Giada F, Gielen S, Hager A, Halle M, Heidbuchel H, Jegier A, Mazic S, McGee H, Mellwig KP, Mendes M, Mezzani A, Pattyn N, Pelliccia A, Piepoli M, Rauch B, Schmidt-Trucksass A, Takken T, van Buuren F, Vanuzzo D. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR. Part II. Eur J Prev Cardiol. 2012;19:1005–1033. Disponible en: https://academic.oup.com/eurjpc/article/19/5/1005/5928135
Fletcher B, Berra K, Ades P, Braun LT, Burke LE, Durstine JL, Fair JM, Fletcher GF, Goff D, Hayman LL, Hiatt WR, Miller NH, Krauss R, Kris-Etherton P, Stone N, Wilterdink J, Winston M. Managing abnormal blood lipids: a collaborative approach. Circulation. 2005;112:3184–3209. Disponible en: https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.105.169180
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in Young competitive athletes: analysis of 1866 deaths in the United States, 19802006. Circulation. 2009;119:1085–1092. Disponible en: https://www.ahajournals.org/doi/10.1161/circulationaha.108.804617
American College of Sports Medicine Position stand. Physic activity, physical fitness, and hypertension. Med Sci Sports Exerc. 1993;25:1-10. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8231750/
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Biociencias

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
-
Reconocimiento — Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios<. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace.
-
NoComercial — No puede utilizar el material para una finalidad comercial.
-
CompartirIgual — Si remezcla, transforma o crea a partir del material, deberá difundir sus contribuciones bajo la misma licencia que el original.
- No hay restricciones adicionales — No puede aplicar términos legales o medidas tecnológicas que legalmente restrinjan realizar aquello que la licencia permite.