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Impact of Physical Activity, Cardiorespiratory Fitness, and Exercise Training on Markers of Inflammation

Lavie, Carl J. MD; Church, Timothy S. MD, MPH, PhD; Milani, Richard V. MD; Earnest, Conrad P. PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: May/June 2011 - Volume 31 - Issue 3 - p 137–145
doi: 10.1097/HCR.0b013e3182122827

Physical activity and exercise training (ET) enhance overall cardiorespiratory fitness (ie, fitness), thus producing many benefits in the primary and secondary prevention of cardiovascular diseases. Substantial evidence also indicates that acute and chronic inflammation is involved in the development and progression of atherosclerosis and major cardiovascular events. The most commonly utilized marker of inflammation is C-reactive protein (CRP). In this review, we discuss the importance of inflammation, especially CRP, as a cardiovascular risk marker by reviewing an abundant cross-sectional and clinical intervention literature providing evidence that physical activity, enhanced fitness, and ET are inversely associated with CRP and that being overweight or obese is directly related with inflammation/CRP. Although we discuss the controversy regarding whether or not ET reduces CRP independent of weight loss, clearly physical activity, improved fitness, and ET are associated with reductions in inflammation and overall cardiovascular risk in both primary and secondary prevention.

We review the evidence supporting the importance of inflammation, and especially C-reactive protein, in cardiovascular diseases. The potential role of physical activity, higher levels of cardiorespiratory fitness, and exercise training to reduce inflammation and levels of C-reactive protein are discussed in detail.

John Ochsner Heart and Vascular Institute, Ochsner Clinical School—The University of Queensland School of Medicine, New Orleans, Louisiana (Drs Lavie and Milani); and Pennington Medical Center, Louisiana State University, Baton Rouge, Louisiana (Drs Church and Earnest).

Correspondence: Carl J. Lavie, MD, John Ochsner Heart and Vascular Institute, 1514 Jefferson Highway, New Orleans, LA 70121 (

© 2011 Lippincott Williams & Wilkins, Inc.