1 / 20

Background

Exercise and Physical Activity in Prevention & Treatment of Civilization Diseases Dr. Rainer Wieching MSc & PhD in Exercise Physiology. Prevention Exercise Training provides lifelong prevention for the most important „Civilization Diseases“.

ziazan
Download Presentation

Background

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Exercise and Physical Activity in Prevention & Treatment ofCivilization DiseasesDr. Rainer WiechingMSc & PhD in Exercise Physiology

  2. PreventionExercise Training provides lifelong prevention for the most important „Civilization Diseases“ TreatmentEvidence Based Medicine proofs a Relative Risk Reduction even better than Drug Treatment Background • DrugsDrugs are expensive togetherwith negative Adverse Events • ExerciseExercise as Medicine (!) with many positive Side Effects

  3. Dyslipidemia Elevatedtriglycerides, Low HDL-C concentrations, High LDL-C concentrations,= independent risk factors for CAD • Drugs -22%Relative Risk Reduction(CV Events) due to Statins…Treating to New Targets (TNT) Investigators. Intensive Lipid Lowering with Atorvastatin in Patients with Stable Coronary Disease. N Engl J Med 2005; 352:1425-1435. • Exercise -35%Relative Risk Reduction (CV Events) due to Exercise…AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2006 Update. Circulation 2006;113;2363-2372.

  4. Obesity • Elevated BMI and Waist Circumference, • Independent Predictor of CAD disease, • Increased Incidence of Metabolic Syndrome • Drugs -24%Relative Risk Reduction (CV Death) due to Rimonabant…Rimonabant, for Management of Obesity.Circulation 2006;114;974-984. • Exercise -22%Relative Risk Reduction(Death) due to Exercise…Trends in 10-Year Predicted Risk of Cardiovascular Disease in the United States, 1976 to 2004. Circ Cardiovasc Qual Outcomes 2009;2;443-450.

  5. Diabetes Directly Associated with CAD, Severe End Organ Damages, Bad Prognosis & High Death Rates, Strongly Growing Incidence Worldwide. • Exercise -58%Relative Risk Reduction(Incidence) due to Exercise…Diabetes Prevention Program Research Group.N Engl J Med 2002;346:393–403. • Drugs -36%Relative Risk Reduction(Mortality) due to Metformin…UK Prospective Diabetes Study Group. (UKPDS 34). Lancet 1998;352:854-65.

  6. Hypertension Independent Risk Factor, of Coronary Artery Disease, Severe End Organ Damages, Globally Important Epidemic, Silent Disease (no pain). • Drugs -66%Relative Risk Reduction(Incidence) due to Candesartan…Trial of Preventing Hypertension (TROPHY) Study Investigators. N Engl J Med 2006; 354 (16) 1685-97. • Exercise -50%Relative Risk Reduction(Incidence) due to Exercise…Exercise and hypertension. Journal of Human Hypertension 2005; 19, 585–587.

  7. CAD (incl. MI) High Incidence in Western Countries,Angina, Myocardial Infarction, High Mortality Rates, Worldwide. • Exercise -27%Relative Risk Reduction(Mortality) due to Exercise…Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2001;(1):CD001800. • Drugs -15%Relative Risk Reduction(Mortality) due to Eplerenone…Eplerenone … in Patients with LV Dysfunction after Myocardial Infarction. N Engl J Med 2003; 348:1309-1321.

  8. Heart Failure Bad Prognosis, High Mortality Rates,High Hospitalizations Rates, Disease of the Elderly. • Drugs -34%Relative Risk Reduction (Mortality) due to ConcorCOR…CIBIS II Investigators and Comittees.Lancet 1999;353:9-13. • Exercise -35%Relative Risk Reduction (Mortality) due to Exercise…Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH).BMJ 2004;328: 189-92.

  9. PAOD Peripheral Claudication, Arterial Occlusive Disease, High Amputation Rates,Associated with CAD, Low Quality of Life. • Drugs +30%Pain Free Walking Distance due to Pentoxiphylline…A comparison of cilostazol and pentoxifylline for treating intermittent claudication.Am J Med. 2000 Nov;109(7):523-30. • Exercise +179%Pain Free Walking Distance due to Exercise…Exercise rehabilitation programs for the treatment of claudication pain: a meta-analysis. JAMA. 1995;274:975–980.

  10. Breast Cancer Very Serious Disease, High Mortality Rates, Psychological Involving, Genetic Predisposition, Bad Prognosis. • Drugs -34%Relative Risk Reduction(OS) due to Herceptin…The Herceptin Adjuvant (HERA) Trial. N Engl J Med 2005;353:1659-72. • Exercise -40%Relative Risk Reduction(Death) due to Exercise…Physical Activity and Survival after Breast Cancer Diagnosis. JAMA. 2005;293:2479-2486.

  11. Colon Cancer Very Serious Disease, High Mortality Rates, HighIncidence, Bad Prognosis. • Drugs -15%Relative Risk Reduction(PFS) due to Erbitux…The CRYSTAL Trial. N Engl J Med 2009;360:1408-17. • Exercise-50%Relative Risk Reduction(Death) due to Exercise… Physical Activity and Survival after Colorectal Cancer Diagnosis. J Cli Onc 2006;24(22):3527-3534.

  12. Lung Cancer Very Serious Disease, High Mortality Rates, HighIncidence, Bad Prognosis. • Drugs -13%Relative Risk Reduction(OS) due to Erbitux…The FLEX Trial. Lancet 2009;373:1525-31. • Exercise-39%Relative Risk Reduction(Incidence) due to Exercise… Physical Activity and Risk of Lung Cancer. Int J Epidemiol 1999;28:620-625.

  13. Stroke (TIA) Growing Incidence Worldwide, High Rates of Disabilities,High Mortality Rates, Families Involved. • Exercise -27%Relative Risk Reduction(of Stroke) due to Exercise…Physical activity and stroke risk: a meta-analysis. Stroke. 2003;34(10):2475-81. • Drugs -30%Relative Risk Reduction (of Stroke) due to Antiplatelet Drugs…Antithrombotic Trialists' Collaboration.BMJ 2002; 324: 71-86.

  14. Alzheimer Growing Incidence Worldwide, Families Seriously Involved, Bad Prognosis, Low Mortality. • Drugs -24%Risk Reduction due to NSAID Treatment…Protective effects of NSAIDs on the development of Alzheimer disease. Neurology 2008;70(19):1672–1677. • Exercise -62%Risk Reduction (of Alzheimer‘s Disease) due to Exercise…Physical activity and the risk of Alzheimer’s disease. Lancet Neurol 2005; 4: 705–11.

  15. Depression Strongly Growing Incidence Families Seriously Involved Very High Mortality RatesSuicides & Death • Drugs -33%Relative Risk Reductiondue to Trevilor…Venlafaxine for Major Depression. BMJ 2007;334:215-6. • Exercise -45%Prevalence of Symptoms Reduction due to Exercise…Exercise … in the Treatment of Major Depressive Disorder. Psychosomatic Medicine 2007;69:587–596.

  16. COPD Stable Incidence Intermediate Mortality RatesExercise Capacity Important Bad Prognosis • Drugs -12%Relative Risk Reduction (Mortality) due to Drug Treatment…Salmeterol and Fluticasone Propionate and Survival in COPD. N Engl J Med 2007;356:775-89. • Exercise -55%Relative Risk Reduction(Mortality) due to Exercise…Respiratory rehabilitation after … COPD … – a systematic review. Respiratory Research 2005, 6:54.

  17. Summary

  18. Conclusion • DrugsSerious Adverse Events Very High Costs => Depression & Fatigue • ExercisePositive Side Effects Low Costs => Active & Well Being…

More Related