Impact of Moderate and Vigorous Physical Activity on Cardiovascular Health: A Review

This article is a narrative review based on literature search primarily on PubMed about connections of physical activity and cardiovascular health. Moderate physical activity increases life expectancy and provides numerous cardiovascular benefits. It reduces the risk of atherosclerosis, atrial fibrillation (AF) incidence, arterial hypertension, hyperlipidemia, and diabetes. Accordingly, the World Health Organization guidelines recommend a minimum of 150 min of moderate physical activity or 75 min of vigorous physical activity per week, or a combination of the intensities of appropriate duration, for adults aged 18–64 years. For additional beneficial health effects, 300 or more minutes of moderate physical activity or 150 or more minutes of vigorous physical activity, with the option of combining training intensities, are recommended. On the other hand, evidence on vigorous physical activity is less clear, and evidence is more conflicting. There is a hypothesis that intense exercise may harm the cardiovascular system, causing enlargement of all heart chambers, myocardial fibrosis (primarily of the right ventricle), and increasing the risk, of coronary artery calcification, AF, and sudden cardiac death. Despite recent advancements, there is no firm evidence on the clinical significance of these conditions. Hence, current recommendations do not advise specific exercise intensity limits. The most important sports medicine task is identifying the athletes with an unacceptably high risk of triggering sudden cardiac death during sports activity and advising them with appropriate recommendations.