Article

Regular aerobic exercise at moderate intensities and an increased physical
fitness are associated with a reduced risk of fatal and nonfatal coronary events
in middle-aged individuals. In contrast, moderate and vigorous physical exertion
is associated with an increased risk for cardiac events, including sudden cardiac
death in individuals harbouring cardiovascular disease. The risk-benefit ratio
may differ in relation to the individual's age, fitness level, and presence of
cardiovascular disease; sedentary individuals with underlying coronary artery
disease are at greatest risk. The intention of the present position stand of the
European Association of Cardiovascular Prevention and Rehabilitation is to
encourage individuals to participate in regular physical activity and derive the
benefits of physical exercise while minimizing the risk of cardiovascular adverse
events. Therefore, the aim is to establish the most practical method of
cardiovascular evaluation in middle-age/senior individuals, who are contemplating
exercise or who are already engaged in nonprofessional competitive or
recreational leisure sporting activity. These recommendations rely on existing
scientific evidence, and in the absence of such, on expert consensus. The
methodology of how middle-aged and older individuals should be evaluated
appropriately before engaging in regular physical activity is both complex and
controversial. On practical grounds the consensus panel recommend that such
evaluation should vary according to the individual's cardiac risk profile and the
intended level of physical activity. Self assessment of the habitual physical
activity level and of the risk factors, are recommended for screening of large
populations. Individuals deemed to be at risk require further evaluation by a
qualified physician. In senior/adult individuals with an increased risk for
coronary events, maximal exercise testing (and possibly further evaluations) is
advocated. Hopefully, the recommendations in this paper provide a practical
solution for facilitating safe exercise prescription in senior/adults.

Langue : ANGLAIS