Increased Exercise Favorably Modifies Coronary Artery Disease and Peripheral Arterial Disease Outcomes

Exercise therapy, especially when supervised on-site in a clinical facility or directed off-site for a home-based program, is an essential component of the management of coronary artery disease (CAD) and peripheral arterial disease (PAD). In the case of both atherosclerotic diseases, it can decrease adverse cardiovascular (CV) events. There has been a recent push toward invasive management of both CAD and PAD but accumulating clinical experience has shown the limitation of invasive management and emphasized the importance of medications, CV risk reduction, conditioning, and exercise, especially when supervised. Exercise results in increased peak oxygen consumption (V0(2)), improvement of welle-stablished CV risk factors such as plasma lipids, and an improvement in indicators of inflammation and of various metabolic factors. Fortunately, there is generally good third-party coverage of medications and vascular interventions but unfortunately, poor insurance coverage for supervised or directed exercise programs for which significant patient benefit has been established.