ABC | Volume 113, Nº4, October 2019

Updated Updated Cardiovascular Prevention Guideline of the Brazilian Society Of Cardiology – 2019 Arq Bras Cardiol. 2019; 113(4):787-891 Chart 8.1 – Main acute and chronic effects of exercise. NO: nítric oxide; VO 2 : oxygen consumption. Acute Endothelial function Cardiac output Muscle blood flow Coronary blood flow Antioxidant enzyme protection Insulin sensitivity Baroreceptor sensitivity Lipolysis Resting metabolic rate Vasoactive substances (bradykinin, NO) Growth hormone Protein synthesis Blood glucose Autonomic system Arterial hypertension Inflammartory markers Postprandial hyperlipemia Pulse wave velocity Ghrelin and peptide YY hormones (appetite regulators) Chronic Endothelial function Maximal VO 2 Telomere length Antioxidant enzyme protection Insulin sensitivity Baroreceptor sensitivity Joint flexibility and mobility Mass, strength, and power muscular Weight management Bone mass Trabecular bone structure Nitrogen economy (protein- sparing effect) Glycosylated hemoglobin Resting and submaximal exercise heart rate Pulse pressure during exercise Autonomic system Arterial stiffness Lipemia Risk of cognitive degenerative diseases (dementia, Alzheimer’s) Anxiety and symptoms associated with depression Risk of falling in elderly A good weekly goal for CVD health promotion and prevention is physical activity/exercise/sport for at least 150 minutes of moderate intensity or 75 minutes of high intensity. 10,342,347 Getting more than 300 minutes per week of moderate to high intensity exercise may provide additional benefit. However, there is no scientific evidence for a clear delineation of an upper limit from which there would be a greater possibility of harm to a healthy individual. 303 More recent studies have associated sedentary time, such as watching television, with higher all-cause mortality, CV mortality, and the risk of developing DM. 348 8.7. Prescription for Exercises Exercises may be prescribed for their characteristics, such as type (aerobic, muscle endurance, flexibility), modality (walking, running, cycling, dancing), duration (running time), weekly frequency and its intensity (Tables 8.4 and 8.5). Previously sedentary patients may begin exercise at the lower end of the prescription and progress to higher intensities gradually over the following weeks. The progression should initially be made in the duration of the session and later in the intensity of the exercises. Already physically active patients, according to individual assessment, can perform exercises at more intense levels, aiming at a minimum of 75 minutes, ideally divided into two or more weekly sessions. Localized muscular endurance and strengthening or power exercises have been shown to be very beneficial for general health and for CV and musculoskeletal systems, being of fundamental importance in patients with sarcopenia and/or osteopenia. They should be performed at least twice a week, favoring large muscle groups of the upper and lower limbs and trunk. They can be made using one’s own body or using attachments such as free weights, shin guards, elastic bands and weight machines. The load or weight for each exercise or movement must be individually adjusted. Due attention 831