Chapter 16. Psychosocial Factors

  1. Salim Yusuf DPhil, FRCPC, FRSC Research Chair Professor of Medicine Director Vice President Research2,3,4,
  2. John A Cairns MD, FRCPC Professor of Medicine Former Dean5,
  3. A John Camm MD British Heart Foundation Professor Head of Cardiac6,
  4. Ernest L Fallen MD, FRCPC Professor Emeritus7 and
  5. Bernard J Gersh MB, ChB, DPhil Consultant Professor of Medicine8
  1. Annika Rosengren MD Professor of Medicine

Published Online: 21 MAY 2010

DOI: 10.1002/9781444309768.ch16

Evidence-Based Cardiology, Third Edition

Evidence-Based Cardiology, Third Edition

How to Cite

Rosengren, A. (2009) Psychosocial Factors, in Evidence-Based Cardiology, Third Edition (eds S. Yusuf, J. A. Cairns, A. J. Camm, E. L. Fallen and B. J. Gersh), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444309768.ch16

Editor Information

  1. 2

    McMaster University, Canada

  2. 3

    Population Health Research Institute, McMaster University, Hamilton Health Sciences, Canada

  3. 4

    Hamilton Health Sciences, Hamilton, Ontario, Canada

  4. 5

    Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

  5. 6

    St George's University of London, London, UK

  6. 7

    McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada

  7. 8

    Mayo Clinic College of Medicine, Rochester, MN, USA

Author Information

  1. Department of Medicine, Sahlgrenska University Hospital/ Ostra, Göteborg, Sweden

Publication History

  1. Published Online: 21 MAY 2010
  2. Published Print: 13 NOV 2009

ISBN Information

Print ISBN: 9781405159258

Online ISBN: 9781444309768



  • exercise;
  • physical activity;
  • cardiorespiratory fitness;
  • cardiovascular disease risk;
  • cardiovascular prevention;
  • cardiovascular rehabilitation


Physical activity and exercise in cardiovascular disease prevention and rehabilitation

A sedentary lifestyle is prevalent in modern society and is an established major modifiable risk factor for cardiovascular disease (CVD). For persons without clinical CVD, amounts of occupational and leisure-time physical activity, as well as cardiorespiratory fitness, are inversely related to CVD risk. For patients with established CVD, observational and randomized trial data consistently demonstrate a lower risk in more physically active individuals. An acute bout of exercise transiently increases the risk of a cardiovascular event, but the absolute risk is very small. The data are consistent with the concept that the greater the total energy expenditure in physical activity, the lower the CVD risk. Potential mechanisms responsible for the cardio-protective action of habitual exercise are not fully understood, but include improvement in classic coronary risk factors, reduction in autonomic nervous system and endothelial cell dysfunction, decreased thrombosis, reduced atherosclerosis progression, and a reduction in myocardial ischemia.