IJCS | Volume 32, Nº4, July/August 2019

DOI: 10.5935/2359-4802.20190062 Claudio Tinoco Mesquita, MD, PhD Editor-in-chief International Journal of Cardiovascular Sciences Universidade Federal Fluminense - UFF claudiotinocomesquita@id.uff.br 313 EDITORIAL International Journal of Cardiovascular Sciences. 2019;32(4):313-316 Mailing Address: Claudio Gil S. Araújo CLINIMEX - Rua Siqueira Campos, 93/101-103. Postal Code: 22031-072, Rio de Janeiro, RJ – Brazil. E-mail: cgaraujo@iis.com.br Physical Activity, Exercise and Sport: A Five-Star Path for a Better Cardiovascular Health Claudio Gil Soares de Araújo 1 a nd Claudio Tinoco Mesquita 2 Clínica de Medicina do Exercício - CLINIMEX, 1 Rio de Janeiro, RJ - Brazil Universidade Federal Fluminense, 2 Niterói, RJ - Brazil ExerciseTest, Exercise;Athletes; CardiacRehabilitation; Sports, Cardiovascular Diseases. Keywords Exercise is not optional: It is essential. Herman Pontzer Why we must exercise? Although this question has many answers, many other questions arise from it. Which are the benefits of exercising? How much exercise is good for health? Is high-intensity exercise better than moderate-intensity exercise? Are there risks in exercising? What to do if someone does not like to exercise? Do cardiologists know the literature on exercise and heart? These are sounding questions that should be covered to understand the real need of exercising. Why is the International Journal of Cardiovascular Sciences having a special thematic issue on exercise and cardiovascular health? Indeed, searching PubMed for the keywords “heart” and “(exercise OR physical activity OR sport) AND heart”, the proportion of papers on exercise and heart were only 1%until mid-60’s, with a fast increase to around 7 to 8% in mid-80’s and thereafter, although there was a significant increase in the absolute number of publications, close to 5,000 papers/year in 2018 (Figure 1). The World Health Organization (WHO) recommends that adults aged from 18 to 64 years should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity. 1 According to the WHO, insufficient regular exercise, also called hypokinesia, has been identified as the fourth leading risk factor for global mortality. 2 Indeed, hypokinesia is likely the most prevalent chronic health disorder around the world, affecting a significant amount of individuals of all ages and both sexes. Recent data from the United States suggested that approximately 80% of their population of adolescents and adults are insufficiently active. 3 A WHO report comparing levels of insufficient activity in 168 countries brought some bad news to our country: 1) 47% of the Brazilian population is sedentary, 2) between 2001, and 2016, the levels of insufficient activity increasedmore than 15% in Brazil, and 3) women in Brazil and in Latin America have the highest levels of insufficient physical activity in the world. 4 The most recent data from Brazil, reported by Vigitel, 5 a long-term project supported by the Brazilian Ministry of Health, indicated that only 37% of our adults – 43.4% of men and 31.5% of women – living in our capitals met the WHO recommendations of a minimal of 150 minutes of medium-intensity exercise or 75minutes of high-intensity exercise, in average, per week. In reverse order, these data mean that 63% of Brazilian adults are hypokinetic! However, it is even more alarming considering that only 23.3% of those older than 65 years of age are physically active. In this age group, the incidence of chronic diseases, including those of cardiovascular origin, which Claudio Gil Soares de Araújo, MD, PhD Director of Research and Education Exercise Medicine Clinic - CLINIMEX cgaraujo@iis.com.br