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Ciccarone Articles

Ciccarone Center Research


Exercise and Physical Fitness

Landmark Articles

  • 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.

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  • 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.
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  • 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.
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Relation of C-reactive protein to abdominal adiposity
By: Brooks GC, Blaha MJ, Blumenthal RS.
The association between high-sensitivity C-reactive protein (hsCRP) and abdominal adiposity persists when taking into account body mass index. Elevation of hsCRP might be reversible with weight loss and exercise. In conclusion, clinical measurements of abdominal adiposity readily provide data elucidating the systemic inflammatory state of patients and can help guide intensity of lifestyle modifications, thus leading to reduction of this inflammation.
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Exercise blood pressure and future cardiovascular death in asymptomatic individuals.
By: Weiss SA, Blumenthal RS, Sharrett AR, Redberg RF, Mora S.
Individuals with exaggerated exercise BP tend to develop future hypertension. It is controversial whether they have higher risk of death from cardiovascular disease (CVD). We found that, in asymptomatic individuals, elevated exercise BP carried higher risk of CVD death but became nonsignificant after accounting for rest BP. However, Bruce stage 2 BP >180/90 mm Hg identified nonhypertensive individuals at higher risk of CVD death.
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Assessment of subclinical coronary atherosclerosis in asymptomatic patients with type 2 diabetes mellitus with single photon emission computed tomography and coronary computed tomography angiography.
By: Choi EK, Chun EJ, Choi SI, Chang SA, Choi SH, Lim S, Rivera JJ, Nasir K, Blumenthal RS, Jang HC, Chang HJ.
We evaluated the characteristics of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus (DM) using single photon emission computed tomography (SPECT) and coronary computed tomographic angiography (CCTA). In conclusion, a significant percentage of patients with DM and normal eletrocardiographic findings, no peripheral arterial disease, and normal findings on SPECT have evidence of occult CAD on CCTA. Furthermore, a small percentage had had a cardiac event by mid-term follow-up.
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