Impact of exercise training on cardiovascular disease and risk.

Epidemiological studies in large cohorts support the notion that physical fitness is associated with reduced cardiovascular mortality and hospitalization due to cardiovascular disease. During the last 20 years even the concept of resting inactive after a myocardial infarction has dramatically changed and nowadays patients are mobilized and included into exercise training programs very shortly after the insult. Unfortunately, these beneficial effects of exercise training are independent of the genetic background and are only observed in case the training program is not paused for a longer time. Therefore, to take advantage of the effects of exercise training in health care the challenge for the future is to increase exercise compliance by offering interesting and effective exercise training programs. At the physiological and molecular level, exercise training affects several organs like the vascular system and the skeletal muscle. Changes elicited by regular exercise training range in the vascular system from increasing vasodilation due to an elevation of bioavailable nitric oxide to a shift in the catabolic/anabolic balance in the peripheral skeletal muscle. In this review we discuss the healthy benefit of exercise training and the molecular changes triggered by exercise training in the setting of secondary prevention.