Sellier P
Service de Rééducation Cardiaque, Hôpital Broussais, Paris, France.
J Cardiovasc Pharmacol. 1995;25 Suppl 1:S9-14. doi: 10.1097/00005344-199525001-00004.
It is well established that a sedentary lifestyle is a risk factor for coronary heart disease. Regular physical activity has a proven beneficial effect in the general population, reducing, in particular, the risk of myocardial infarction. In patients who have had a myocardial infarction, long-term physical exercise at a sufficiently intense level has a beneficial effect on morbidity and mortality. Although there is no statistical proof, it appears that this effect is accompanied by a slight increase in the risk for nonfatal myocardial infarction. The effects of physical activity on other heart diseases are not well known. The mechanisms by which physical exercise exerts its protective effect are not yet well established. Among the proposed hypotheses are the effect on peripheral muscle of physical training, the reduction of myocardial ischemia, and modifications of the adrenergic response to effort and stress. Moreover, physical training has a favorable effect on certain risk factors for coronary heart disease (e.g., lipids profile, arterial hypertension, smoking). The risks involved with physical training in cardiac patients can be evaluated from the data collected from rehabilitation programs. These risks are very slight, provided that the patients are carefully selected.
久坐不动的生活方式是冠心病的一个危险因素，这一点已得到充分证实。规律的体育活动对普通人群有已被证实的有益作用，特别是能降低心肌梗死的风险。在曾发生过心肌梗死的患者中，长期进行足够强度的体育锻炼对发病率和死亡率有有益影响。尽管没有统计学证据，但这种影响似乎伴随着非致命性心肌梗死风险的轻微增加。体育活动对其他心脏病的影响尚不清楚。体育锻炼发挥其保护作用的机制尚未完全明确。提出的假设包括体育训练对周围肌肉的影响、心肌缺血的减轻以及对运动和应激时肾上腺素能反应的改变。此外，体育训练对冠心病的某些危险因素（如血脂谱、动脉高血压、吸烟）有有利影响。心脏疾病患者体育训练的相关风险可以从康复项目收集的数据中进行评估。只要对患者进行仔细挑选，这些风险是非常小的。
