**2. Exercise training and the primary, secondary and tertiary prevention of cardiovascular disease**

Although more than 200 risk factors have now been identified that can give rise to CVD, the major risk factors of smoking, hypertension, dyslipidemia and physical inactivity have been recognised for over 50 years [6, 7]. Problematically, the 200 or so risk factors often perform complex interactions and may act synergistically acting to amplify the damage caused by any one risk factor alone [8]. Despite the existence of proven strategies for the prevention and management of CVD risk, millions of individuals worldwide continue to develop and display behaviours and characteristics that increase the risk for developing CVD.

In this regard, physical inactivity, while listed as the fourth leading cause of death worldwide [6], is modifiable with an overwhelming body of evidence demonstrating the benefits of physical activity for cardiovascular health. Physical activity can both modify individual risk factors, but it also reduces overall risk of CVD [9]. As such, evidence supports the inclusion of exercise training in a) the primary prevention (preventing the onset of CVD) [10], b) secondary prevention (reducing the impact of CVD prior to any critical or permanent damage to health) [11] and c) tertiary prevention of CVD (slowing, arresting, or reversing CVD to prevent further deterioration, and reduce the risk of subsequent events) [12]. In addition, physical exercise can be employed in low, middle or high income countries [13].
