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Cohort study
Vigorous intensity exercise is essentially safe for coronary heart disease patients
  1. David Swain
  1. Department of Human Movement Sciences, Old Dominion University, Norfolk, Virginia, USA
  1. Correspondence to: David Swain
    Department of Human Movement Sciences, Old Dominion University, SRC 2024, Norfolk, VA 23529, USA; dswain{at}

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Commentary on: Rognmo O, Moholdt T, Bakken H, et al. Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation 2012;126:1436–40.


Aerobic exercise is beneficial for the prevention and treatment of coronary heart disease (CHD). Prescribing such exercise involves frequency, intensity, duration and total volume.1 Regarding intensity, the question of safety is often raised. Increased sympathetic drive during exercise increases clotting and ventricular excitability, and can trigger coronary events. Acute vigorous intensity exercise significantly increases the risk of myocardial infarction2 (MI) and cardiac arrest.3

Chronic vigorous intensity exercise increases aerobic capacity4 and reduces the risk of CHD5 more than moderate intensity. Research in Norway has demonstrated superior patient …

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