AHA Scientific Statement on Long-Term Exercise and Cardiovas
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This American Heart Association (AHA) Scientific Statement discusses the cardiovascular and health implications of moderate to vigorous physical activity.

Cardioprotective effects of regular physical exercise include antiatherosclerotic, antiarrhythmia, anti-ischemic, antithrombotic, and psychological factors.

More recommendations are enlisted below.
1. AMI and SCD risks are higher in association when physical activity is strenuous, sudden, unaccustomed, or involves high levels of anaerobic metabolism.
2. Recent evidence suggests that nonacute coronary disease and exercise-induced myocardial ischemia (rather than acute plaque rupture) are the cause of most exercise-related SCD in middle-aged adults, and that acute plaque rupture is the second most common cause.
3. Exercise training is accepted to have a deleterious effect on arrhythmogenic right ventricular cardiomyopathy. However, it is unknown whether high-volume, high-intensity endurance exercise training induces similar negative effects on other genetic cardiac conditions.
4. New recommendations for exercise screening are summarized in the following four points:
- Physically active asymptomatic individuals without known cardiovascular, metabolic, or renal disease (CMRD) may continue their usual moderate or vigorous exercise and progress gradually as tolerated. Those who develop signs or symptoms of CMRD should immediately discontinue exercise and seek guidance from a medical professional before resuming exercise of any intensity.
- Physically active asymptomatic individuals with known CMRD who have been medically evaluated within 12 months may continue a moderate-intensity exercise program unless they develop signs or symptoms, which requires immediate cessation of exercise and medical reassessment.
- Physically inactive individuals without known CMRD may begin light- to moderate-intensity exercise without medical guidance and, provided they remain asymptomatic, progress gradually in intensity.
- Physically inactive individuals with known CMRD or signs/symptoms that are suggestive of these diseases should seek medical guidance before starting an exercise program, regardless of the intensity.
5. The AHA/American College of Cardiology scientific statement concluding that available data do not support a public health benefit from using 12-lead ECG as a universal screening tool for athletes is in contrast to a European Society of Cardiology recommendation.
6. Long-term exercise training is associated with benign alterations of cardiac structure and function.
7. Supervised exercise training and habitual physical activity are a Class I recommendation for patients with cardiovascular disease.
8. Patients should be counseled to include a warm-up and a cool-down period during exercise training. Previously inactive patients with or without known cardiovascular disease should be counseled to avoid unaccustomed, vigorous physical exertion and highly strenuous physical activities, to recognize potential exertional-related warning symptoms and signs, and to adapt exercise to the environment.

Source: American colege of Cardiology
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