**1. Introduction**

The leading causes of death are due to cardiovascular disease (CVD), contributing substantially to increased health expenditure in several countries [1]. Thus, physical inactivity, obesity, smoking, and diabetes mellitus increased the risk for CVD [1]. Currently, sedentarism has been recognized as a primary risk factor, and physical exercise is associated with a decreased mortality rate from coronary artery disease [2]. Thus, a sedentary lifestyle is characterized as any waking behavior whose energy expenditure is less than 1.5 METs (metabolic equivalent), sitting, reclining, or lying down. This behavior differs from physical inactivity, which the individual does not perform moderate-vigorous physical activities [3].

Among the cardiovascular benefits of exercise, it is possible to observe blood pressure reductions, resting bradycardia, and greater efficiency of the cardiovascular system [4]. Also, cardioprotective factors are observed with exercise training such as the reduction of the magnitude of myocardial infarction [5], through different mechanisms, such as reduction of the inflammatory process, molecular regulation, as well as control of the pathological cardiac hypertrophy [5]. However, not every exercise stimulus promotes the same responses. Thus, it is necessary to know how much and what type of exercise should be applied to generate cardioprotective effects. For the prescription of exercises, it is essential to emphasize the variables that make up the activity: the FITT (frequency, intensity, type, and time) [6].

Aerobic exercise is considered a strategy for the prevention/treatment of arterial hypertension in reducing the risk of cardiovascular disease. The intensity of these exercises ranges from 40 to 60% of VO2max or 11 to 14 of the perceived effort (Borg Scale). Current studies show that reductions in blood pressure by aerobic exercise are directly linked to intensity, so more vigorous activity may result in more significant reductions in blood pressure [6]. Frequency can range from 3 to 7 days a week [7, 8], and it is recommended to use large muscle groups, lasting 30–60 min [6]. Besides, several studies using resistance training (RT) as an intervention proposal are performed. Recent data indicate that RT has antihypertensive effects and can be used as a treatment strategy when combining with aerobic exercise [9, 10].

Consequently, exercise adaptations result in structural and physiological changes imposed on the heart. In this sense, cardiac remodeling occurs in different situations, which may be beneficial or harmful and widely studied in several aspects. Therefore, the purpose of this chapter is to review the aspects of cardiac remodeling associated with physical exercise.
