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CLINICAL NEWS JACC in a FLASH The authors found that volumes of moderate and vigorous exercise below recommendations resulted in significantly lower mortality risk. calcium scores. Two recent studies reported a U-shaped relationship between aerobic exercise volumes and cardiovascular morbidity and mortality in the general population. However, findings also show that daily exercise regardless of activity may reduce the incidence the incidence of cerebrovascular disease and venous thromboembolism. Any volume of strenuous exercise may also reduce the risk for incident coronary artery disease. Exerciseinduced changes in cardiac structure and function are usually related to the volume and intensity of athletic activity. However, the authors explain that while the long-term implications are currently unknown, it is unlikely these are similar to the risk classifications seen in CVD patients. Many endurance athletes experience cardiovascular benefits as well. “Even though exercise and exercise UNRESTRICTED COMMERCIAL AND MEDICARE PART D FORMULARY COVERAGE NATIONWIDE FOR YOUR PATIENTS ON EFFIENT® (PRASUGREL) NATIONAL COVERAGE FOR EFFIENT* 90 + 88 % Commercial† % Medicare Part D‡ *Access defined as unrestricted lowest brand co-pay (LBC) or 2nd LBC. The paper also explored the role of exercise as a key component in secondary prevention for patients with CVD. Guidelines from the ACC and the American Heart Association recommend 30–60 minutes of moderate intensity aerobic exercises per day, and also advise patients to included resistance exercise training. Patients with certain conditions, such as myocardial infarction, recent cardiac surgery or a percutaneous coronary intervention are eligible for cardiac rehabilitation, which includes exercise training. While there are obvious benefits from exercise for patients with CVD, high volumes of exercise may be harmful. However, the paper highlights recent studies that have found high intensity interval training may be beneficial. Lastly, the paper looks at the controversy surrounding excessive exercise. Multiple studies have found that endurance athletes may be at a higher risk for adverse cardiovascular outcomes. Large volumes of intense exercise may lead to increased risk for atrial fibrillation, post-exercise decreases in left and right ventricular function, and increased coronary artery 14 Approximately 73%† of commercial and 80%‡ of Medicare Part D patients have unrestricted access to Effient at the LBC amount or better Source: Managed Markets Insight & Technology (MMIT), LLC as of June 2015, and is subject to change without notice by a health plan or state. Please contact the plan or state for the most current information This information is not a guarantee of coverage or payment (partial or full). Actual benefits are determined by each plan administrator in accordance with its respective policy and procedures Formulary information in this document does not establish clinical comparability of products and should not be seen as making any claim regarding efficacy or safety CardioSource WorldNews