Adaptações cardiovasculares ao treinamento físico: bases fisiológicas e evidências em saúde e doença

Resumo (EN)

Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide, and physical inactivity is one of the main modifiable risk factors associated with adverse outcomes. This narrative review aimed to synthesize the evidence on the effects of physical exercise on cardiovascular physiology, encompassing central and peripheral adaptations related to aerobic capacity (VO2max), acute hemodynamic responses, and exercise-induced cardiac remodeling, as well as the impact of these adaptations in cardiovascular diseases. Searches were conducted in the MEDLINE, PubMed, SciELO and Virtual Health Library (BVS) databases, prioritizing publications from the last 20 years and including original studies, reviews and guidelines. The analyzed studies show that regular training, whether aerobic, resistance, interval, or combined, promotes increases in VO2max, reductions in resting heart rate, improvements in cardiac output and endothelial function, and favors structural cardiac adaptations consistent with the so-called “athlete’s heart”. In individuals with coronary artery disease, heart failure, hypertension and peripheral arterial disease, structured exercise and cardiac rehabilitation programs are associated with improvements in functional capacity, quality of life, risk factor control and reduction of clinical events. The dose-response relationships between exercise and health benefits are generally inverse and curvilinear, with substantial gains observed when individuals transition from sedentary behavior to minimal recommended levels of physical activity. Overall, the literature reinforces physical exercise as a central intervention for the prevention and treatment of cardiovascular diseases, requiring individualized, clinically guided, evidence-based prescription.