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Ciccarone Center Research

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Exercise and Physical Fitness

Landmark Articles

  • A clinician’s guide to the updated ABCs of cardiovascular disease prevention.

    To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.

    Published in: Journal of the American Heart Association
    Read on Pubmed
  • Low-risk lifestyle, coronary calcium, cardiovascular events, and mortality: Results from MESA.
    Unhealthy lifestyle habits are a major contributor to coronary artery disease (CAD). The purpose of the study was to investigate the associations of smoking, weight maintenance, physical activity, and Mediterranean-style diet with coronary calcium, cardiovascular events, and mortality. We discovered that, over the course of nearly 8 years, a combination of regular exercise, healthy diet, smoking avoidance, and weight maintenance contributed to lower coronary calcium incidence, slower calcium progression, and lower all-cause mortality.
    Published in: American Journal of Epidemiology
    Read on Pubmed
  • Effects of physical activity on cardiovascular disease.
    Much attention has been directed toward lifestyle modifications as effective means of reducing cardiovascular disease risk. We review recent observational and interventional trials investigating the effects of physical activity on markers of (or causal factors for) atherosclerotic burden and vascular disease. There is a strong correlation between physical activity and triglyceride reduction, apolipoprotein B reduction, HDL increase, change in LDL particle size, increase in tissue plasminogen activator activity, and decrease in CAC. Further research is needed to elucidate the effect on inflammatory markers and intima-media thickness.
    Published in: American Journal of Cardiology
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The prognostic value of exercise capacity in patients with coronary artery disease: The FIT Project.
By: Hung RK, Al-Mallah MH, McEvoy JW, Whelton SP, Blumenthal RS, Nasir K, Schairer JR, Brawner C, Alam M, Keteyian SJ, Blaha MJ.
Exercise capacity was a strong predictor of morbidity and mortality in patients with coronary artery disease. Patients with similar exercise capacities had equivalent mortality risk, irrespective of baseline revascularization status.
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A clinician’s guide to the updated ABCs of cardiovascular disease prevention.
By: Kohli P, Whelton SP, Hsu S, Yancy CW, Stone NJ, Chrispin J, Gilotra NA, Houston B, Ashen MD, Martin SS, Joshi PH, McEvoy JW, Gluckman TJ, Michos ED, Blaha MJ, Blumenthal RS.

To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.

Read on Pubmed
Rationale and design of the Henry Ford exercise testing project (The FIT Project).
By: Al-Mallah MH, Keteyian SJ, Brawner CA, Whelton S, Blaha MJ.
The FIT Project, the largest study of physical fitness to date, uses electronic clinical epidemiologic techniques to answer many clinically relevant questions related to exercise capacity and prognosis.
Read on Pubmed
New insights into diagnostic testing guidelines in women.
By: Metkus Jr. TS, Blumenthal RS, Joshi PH.

An update to the 2005 Guidelines on the Role of Noninvastive Testing in the Clinical Evaluation of Women with Suspected Ischemic Heart Disease was authored in response to the documented gap in appropriate diagnosis and treatment of ischemic heart disease between women and men.

Does hormone therapy affect blood pressure changes in the Diabetes Prevention Program?
By: Kim C, Golden SH, Kong S, Nan B, Mather KJ, Barrett-Connor, Diabetes Prevention Program Research Group.

Among overweight women with dysglycemia, the magnitude of blood pressure reductions after intensive lifestyle change is unrelated to postmenopausal estrogen use.

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Coronary artery calcium and physical fitness — the two best predictors of long-term survival.
By: Blaha MJ, Feldman DI, Nasir K.
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Delayed heart rate recovery is strongly associated with early and late stage prehypertension during exercise stress testing.
By: Aneni E, Roberson LL, Shaharyar S, Blaha MJ, Agatston A, Blumenthal RS, Meneghelo RS, Conceiçao RD, Nasir K, Santos RD.
Among asymptomatic patients undergoing stress testing delayed HRR was independently associated with early and late stages of prehypertension. Further studies are needed to determine the usefulness of HRR measure in the prevention and management of hypertension.
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2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk.
By: Abd TT, Misra S, Ojeifo O, Martin SS, Blumenthal RS, Foody J, Wong ND.
The 2013 lifestyle guidelines provide guidance in three narrowly focused areas: 1) the effect of dietary patterns and macronutrient composition on CVD risk factors; 2) the effect of sodium and potassium on CVD risk factors; and 3) the effect of physical activity on blood pressure and lipids.
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Delayed heart rate recovery is strongly associated with early and late-stage prehypertension during exercise stress testing.
By: Aneni E, Roberson LL, Shaharyar S, Blaha MJ, Agatston AA, Blumenthal RS, Meneghelo RS, Conceiçao RD, Nasir K, Santos RD.
Among asymptomatic patients undergoing stress testing, delayed heart rate recovery was independently associated with early and late stages of prehypertension.
Read on Pubmed
Relation between self-reported physical activity level, fitness, and cardiometabolic risk.
By: Minder CM, Shaya GE, Michos ED, Keenan TE, Blumenthal RS, Nasir K, Carvalho JA, Conceição RD, Santos RD, Blaha MJ.
Self-reported physical activity level and directly measured fitness are moderately correlated, and the latter is more strongly associated with a protective cardiovascular risk profile.
Read on Pubmed