Coronary artery disease, that is, angina pectoris or myocardial infarction, is one of our most widespread public diseases. Coronary artery disease involves the presence of pathological changes, arteriosclerosis, in the walls of one or more of the coronary vessels.
Physical inactivity is a potent risk factor for coronary artery disease, but old age, male gender and heredity, as well as smoking, high blood pressure, blood lipid disorders, diabetes and overweight also increase the risk of developing the disease.
Prescribing a minimum of 30 minutes per day of regular physical activity constitutes excellent primary prevention against coronary artery disease, and regular exercise, aerobic exercise 3–5 times per week and resistance exercise 2–3 times per week, is a powerful treatment for already established coronary artery disease.
A recommendation to increase physical activity can be given generally in a primary preventive aim, but in order to plan optimal exercise as secondary prevention requires that the patient be tested with respect to aerobic fitness and muscle function.
The assessment begins with a stress test/fitness test with ECG monitoring, a muscle function test, and assessment of the current level of physical activity. Based on these tests and the patient’s general condition, a risk assessment is made, and thereafter an appropriate exercise programme and physical activity level is drawn up for the patient.
It is essential that the initial rehabilitation is carried out under supervision, preferably that of a specialized physiotherapist and access to emergency care equipment.
Most patients exercise for 3–6 months under the direction of cardiac rehabilitation, and most often the exercise can then continue outside the hospital’s management when the condition has been properly stabilized.