Appropriately designed exercise training programs in high-risk cardiovascular populations yield functional and quality-of-life gains that match or exceed those in more traditional populations.
This AHA scientific statement highlights the safety, efficacy, and necessity of tailored exercise training programs for high-risk cardiovascular populations to improve functional capacity and quality of life.
There is broad consensus on the benefits of aerobic exercise training in patients with cardiovascular disease to improve cardiorespiratory fitness and lower the risk of adverse cardiovascular events. However, certain high-risk populations such as those with frailty, stroke, spinal cord injury, rheumatological conditions, or genetic cardiomyopathies and recipients of advanced heart failure therapies or cardiac implantable electronic devices warrant special considerations with regard to exercise training. This scientific statement summarizes the present state and future directions of exercise training for these high-risk populations, including functional deficits, responses to exercise training, modifications in training programs required to maximize safety and efficacy, and knowledge gaps in this field. Key findings common across most of these high-risk populations include (1) increased barriers to participation in exercise training at multiple levels; (2) low baseline cardiorespiratory fitness, creating heightened need for exercise interventions; (3) modifications to exercise prescription, frequently emphasizing strength, balance, and flexibility in addition to aerobic training, as well as accommodations with enhanced supervision and specialized equipment as needed; and (4) functional and quality-of-life gains in response to appropriately designed exercise programs that match or exceed those in more traditional populations. Future research is needed to further develop patient-centered training regimens designed to address the unique and heterogeneous needs of these populations, evaluate their impact on clinical and patient-centered outcomes, and advance scalable and equitable delivery of exercise therapies proven safe and effective.
This new scientific statement from the AHA provides guidance on exercise training for various high-risk cardiovascular populations, addressing a critical and often overlooked aspect of patient care.
Fleg et al. (Thu,) conducted a review in High-risk populations with cardiovascular disease (e.g., frailty, stroke, spinal cord injury, genetic cardiomyopathies). Exercise training was evaluated. Appropriately designed exercise training programs in high-risk cardiovascular populations yield functional and quality-of-life gains that match or exceed those in more traditional populations.