Exercise and cardiovascular disease: Emphasis on efficacy, dosing, and adverse effects and toxicity

Physical inactivity is one of the greatest threats to health in the United States and throughout most of the world. Many studies have demonstrated a linear relationship between physical activity level and reduction in cardiovascular and all-cause morbidity and mortality. However, there is evolving evidence that high levels of exercise may produce similar or less overall benefit than lower doses of exercise. Very high doses of exercise may be associated with increased risk of coronary heart disease, atrial fibrillation, and sudden cardiac death. The benefits of exercise training, recommendations to optimize the dose of exercise to achieve maximal benefit, and potential cardiotoxicity of excessive exercise are reviewed in this chapter