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Aging and disease    2020, Vol. 11 Issue (2) : 327-340     DOI: 10.14336/AD.2019.0516
Review Article |
A Review of Exercise as Medicine in Cardiovascular Disease: Pathology and Mechanism
Piotr Gronek1,*, Dariusz Wielinski2, Piotr Cyganski3, Andrzej Rynkiewicz3, Adam Zając4, Adam Maszczyk5, Joanna Gronek1, Robert Podstawski6, Wojciech Czarny7, Stefan Balko8, Cain CT. Clark9, Roman Celka1
1Laboratory of Genetics, Department of Dance and Gymnastics, Poznań University of Physical Education, Poznań, Poland.
2 Department of Anthropology and Biometry, Poznań University of Physical Education, Poznań, Poland.
3Department of Cardiology and Cardiosurgery, Ist Cardiology Clinic, City Hospital in Olsztyn, University of Warmia and Mazury in Olsztyn, Poland.
4Department of Sports Training, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland.
5Department of Methodology and Statistics, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland.
6Department of Physical Education and Sport, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
7Department of Human Sciences, University of Rzeszow, Rzeszów, Poland.
8Department of Physical Education and Sport, Faculty of Education, Jan Evangelista Purkyne University in Usti nad Labem, Czech Republic.
9School of Life Sciences, Coventry University, Coventry, CV1 5FB, United Kingdom.
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Abstract  Background

Physical inactivity and resultant lower energy expenditure contribute unequivocally to cardiovascular diseases, such as coronary artery disease and stroke, which are considered major causes of disability and mortality worldwide.


The aim of the study was to investigate the influence of physical activity (PA) and exercise on different aspects of health - genetics, endothelium function, blood pressure, lipid concentrations, glucose intolerance, thrombosis, and self - satisfaction. Materials and


In this article, we conducted a narrative review of the influence PA and exercise have on the cardiovascular system, risk factors of cardiovascular diseases, searching the online databases; Web of Science, PubMed and Google Scholar, and, subsequently, discuss possible mechanisms of this action.

Results and Discussion

Based on our narrative review of literature, discussed the effects of PA on telomere length, nitric oxide synthesis, thrombosis risk, blood pressure, serum glucose, cholesterol and triglycerides levels, and indicated possible mechanisms by which physical training may lead to improvement in chronic cardiovascular diseases.


PA is effective for the improvement of exercise tolerance, lipid concentrations, blood pressure, it may also reduce the serum glucose level and risk of thrombosis, thus should be advocated concomitant to, or in some cases instead of, traditional drug-therapy.

Keywords physical activity      longevity      cardiovascular disease      public health problem      aging     
Corresponding Authors: Gronek Piotr   
About author:

These authors contributed equally to this work.

Just Accepted Date: 02 July 2019   Issue Date: 13 March 2020
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Gronek Piotr
Wielinski Dariusz
Cyganski Piotr
Rynkiewicz Andrzej
Zając Adam
Maszczyk Adam
Gronek Joanna
Podstawski Robert
Czarny Wojciech
Balko Stefan
CT. Clark Cain
Celka Roman
Cite this article:   
Gronek Piotr,Wielinski Dariusz,Cyganski Piotr, et al. A Review of Exercise as Medicine in Cardiovascular Disease: Pathology and Mechanism[J]. Aging and disease, 2020, 11(2): 327-340.
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ParticipantsType of ExerciseInfluence on Telomere LengthRef
123 males (56 healthy non - maraton runners, 67 ultra - maraton runners)Ultra - maraton running, exercise 40 - 100 km/week, ?2 yearsLonger leukocyte telomere length in runners vs. non - runners[27]
62 adults (20 athletes, 42 sedentary controls)Endurance exerciseLonger salivary telomere length in endurance athletes vs. sedentary control[28]
2401 white twin adultsSelf - reported physical activity (4 groups based on physical activity levels)Longer leukocyte telomere length with increasing exercise level[29]
69 healthy adultsVarious aerobic exercise (divided into quartiles based on exercise energy
Expenditure: 0-990, 991-2340, 2341-3540, and 93541 kcal/wk)
Longer leukocyte telomere length in 2nd quartile vs. 1st and 4th quartile. Same telomere length in 2nd quartile vs. 3rd quartile.[30]
44 healthy postmenopausal women (21 sedentary subjects, 23 habitual exercise participants)Aerobic and resistance exercise for 60± minutes, >3 times per week, for > 12 monthsLonger leukocyte telomere length in aerobic and resistance exercise participants vs sedentary subjects.[31]
14 healthy adults (7 non - lifters, 7 power lifters)Power lifting; 8±3 yearsLonger skeletal muscle telomere length in power lifters vs non - lifters.[32]
20 young and older men (10 medium activity level, 10 endurance athletes).Endurance exercise (long distance skiing & track running competitions); Medium activity (moderately physically active)Longer skeletal muscle telomere length in older athletes vs older medium - activity individuals. Same telomere length in young athletes vs young medium - activity individuals.[33]
7,813 adult womenEight possible physical activitiesIncrease in leukocyte telomere length (0.10-SD) was observed when comparing the most to the least active women.[34]
944 adults with stable coronary heart diseaseSelf - reported physical activityShorter telomere length
associated with physical activity, but not after multivariate adjustment.
32 adults (15 sedentary healthy subjects, 17 marathon runners)Marathon running, 32±9 miles/week, 14±11 yearsSame leukocyte telomere length in runners vs. sedentary subjects[36]
37 adults (19 sedentary subjects, 18 endurance runners)Endurance running: 40 km/week, ?7 yearsSame (skeletal muscle) telomere length in runners vs. sedentary individuals. Shorter telomere length in subjects with longer exercise history vs. shorter training history. Shorter telomere length in subjects with greater volume of training hours vs. lower volume of training hours.[37]
25 healthy young and 32 older adultsVigorous aerobic exercise ?5 days/week, >45 min/Day, ?5 yearsSame leukocyte telomere length in older athletes vs. older sedentary subjects.[38]
Table 1  Effect of exercise on telomere length.
Figure 1.  Summary of main pathways effect of aerobic exercise.
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