Interactions between genes and physical activity in cardiovascular disease
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Corresponding author Molly S. Bray, PhD Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Suite 8070, Houston, TX 77030, USA. E-mail: [email protected] Current Cardiovascular Risk Reports 2008, 2:318 –324 Current Medicine Group LLC ISSN 1932-9520 Copyright © 2008 by Current Medicine Group LLC
Lifestyle factors such as smoking, poor diet, physical inactivity, and excess alcohol consumption are strongly associated with increased risk of cardiovascular disease (CVD). Family history of premature CVD is also a robust predictor of CVD events, and it is well established that genetic variation plays a role in the development of CVD. Participation in regular exercise improves most risk factors, including lipid abnormalities, diabetes mellitus, hypertension, and obesity. What is less well known is how genes and exercise interact to influence overall CVD outcomes. This review summarizes the current literature on interactions between genes and exercise in CVD.
Introduction Cardiovascular disease (CVD) affects millions of Americans, with an annual cost of almost $450 billion in medical care and lost productivity [1]. CVD has been attributed to genetic, social, psychological, physiologic, nutritional, and socioeconomic influences, implying that not just one variable but multiple, interacting variables likely affect the development of heart disease and related conditions. Intervention programs for CVD that focus on behaviors such as diet or exercise often produce heterogeneous responses, and the variability observed in response to such programs may be due, in part, to interindividual variation in genes. To develop efficacious programs to prevent and treat CVD, it is critical to understand how genetic variation may influence CVD risk and response to alterations in environmental and behavioral factors. This review focuses on the interaction among genes, exercise, and physical activity in the development of CVD.
Exercise and Health The relationship among physical activity, CVD risk, and longevity has been fi rmly established, beginning with the classic studies of Paffenbarger and Hale [2], Morris et al., [3], Taylor et al. [4], and others indicating that individuals in more active professions (eg, bus conductors, postal carriers, longshoremen, railroad workers) experienced a significantly lower risk of CVD and all-cause mortality than their sedentary counterparts. A landmark study of 10,224 men and 3120 women by Blair and Brodney [5] concluded that higher levels of physical fitness (adjusted for age, smoking habits, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval) were independently associated with a lower risk of all-cause mortality, primarily due to lowered rates of CVD and cancer [5]. Results from the Amsterdam Growth and Health Longitudinal Study suggested that, of all lifestyle factors examined (daily physical activity, dietary intake, smoking habits, and alcohol consumptio
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