[Physical exercise in secondary prevention of coronary heart disease].

Addition of life style intervention to pharmacological therapy has been shown to be essential for secondary prevention of cardiovascular diseases. The American Heart Association and American College of Sports Medicine propose physical activity of moderate intensity using dynamic exercise not causing myocardial ischemia and recommend four to five training sessions (30-40 min each) per week. Such activity has been shown to improve prognosis in coronary heart disease. This can be explained by exercise induced improvements of cardiovascular risk factors e.g. dyslipoproteinemia, insulin resistance and inflammation, normalization of endothelial function and retardation of atherosclerosis. Because of the strong evidence of the benefit of exercise in cardiovascular prevention and rehabilitation, this approach should be included in the complex therapy of cardiovascular patients.