ABSTRACT
Disease .............................................................................................. 178 4.4.3 Physical Activity Recommendations for Prevention of Coronary
Heart Disease .................................................................................... 179 Acknowledgment ................................................................................................... 180 References .............................................................................................................. 180
Coronary heart disease (CHD) and its primary cause, atherosclerosis, are the leading causes of mortality in developed countries and the number one killer of both men and women in the United States. Every year since 1919, CHD was ranked as the number one killer in the United States; in 2008, CHD accounted for approximately 32% of all deaths with direct and total costs being estimated to be $273 and $444 billion, respectively.1-4 Interestingly, there has been an almost 50% decline in mortality from heart disease between the 1960s and the 1990s, a decline that has continued through the last decade with the latest reported decline in age-adjusted mortality of approximately 6.7% to 6.0% between 2006 and 2010.5,6 The decline in mortality is due in part to better control of most of the traditional risk factors, that is, reduced smoking rates and better pharmaceutical control of hypertension, diabetes, and the dyslipidemias.6-9 In addition to controlling risk factors, various technologies for treating CHD patients have undergone tremendous improvements over the same time frame and account for as much as one-half of the total decline in mortality.10-13 However, the traditional risk factor obesity has increased in prevalence, and risk behaviors such as physical activity and dietary patterns have been difficult to improve given current trends in technology, automation, and food production.
