Physical training--beyond increasing exercise capacity.

Physical training has traditionally represented the main method used in cardiovascular rehabilitation of ischemic patients in the past years. Nowadays, cardiovascular rehabilitation has been extended to other cardiovascular diseases, such as heart failure. Also, cardiovascular rehabilitation included psychological, social and professional measures along with secondary prevention methods such as lifestyle changes. It has also been found that physical training has other additional effects which increased exercise tolerance. Effects on the risk factors regard beneficial effect on body weight, on the serum lipids levels, on psychosocial stress, on high blood pressure and on insulin resistance and diabetes mellitus. Physical exercise has also beneficial effects on the balance between sympathetic--vagal tone, inducing a vagal predominance, has anti-atherogenic and anti-ischemic effects, influencing the endothelial function, the inflammation (anti-inflammatory effect), both arteriogenesis and angiogenesis and thrombosis. Physical training could improve the symptoms of coronary patients by preconditioning, which has a protective effect for the myocardium. We may state that physical exercise has beneficial effects in cardiovascular patients because it increases exercise tolerance with positive consequences on the quality of life and professional reintegration, but also because it has positive effects beyond this. Thus, physical exercise should be practiced through cardiac rehabilitation programs, by all cardiovascular patients.