The Benefits of Exercise for Cardiovascular Health

Regular exercise has long been recognized as a key factor in maintaining cardiovascular health and preventing various cardiovascular diseases (CVDs). A recent study published in the Progress in Cardiovascular Diseases Journal sheds light on the impact of exercise on cardiovascular well-being.

Background: Numerous studies have demonstrated that regular exercise, spanning several decades, serves as an effective primary and secondary protection against a range of health issues, including CVDs, hypertension, obesity, diabetes, and premature mortality. Even small increases in physical activity (PA) can lead to significant risk reduction, making it a crucial aspect of population health. Both resistance and aerobic exercise training can considerably lower the risk of CVD, even if the recommended exercise guidelines are not fully met.

Effects and Advantages of Exercise on CVD: Diabetes Mellitus (DM): Both resistance and aerobic exercises can improve glycemic control, enhance insulin response, reduce adipose tissue (particularly visceral abdominal fat), and promote weight loss in individuals with prediabetes and type 2 diabetes (DM2). Exercise can protect against metabolic syndrome and may be used as a therapy for patients with DM2, leading to a reduced burden of CVD.

Hypertension (HTN): Aerobic exercise and resistance training, including isotonic and isometric exercises, effectively lower blood pressure, in addition to the recommended Dietary Approaches to Stop Hypertension (DASH) diet. Moderate to high-intensity resistance training and aerobic exercise can decrease systolic and diastolic blood pressure by two to five mm Hg in normotensive individuals and five to seven mm Hg in individuals with HTN. The effects depend on the duration, frequency, and intensity of PA.

Coronary Artery Disease (CAD): Regular exercise helps reduce risk factors associated with CAD, such as hyperlipidemia and HTN. Furthermore, exercise can improve coronary arterial function, slowing down the development and progression of CAD. Research suggests that engaging in moderate exercise for five to six hours per week can lead to a reduction in coronary plaques. Combining exercise with optimal medical therapy is comparable to percutaneous coronary intervention (PCI) for patients with small areas of ischemia.

Heart Failure (HF): Physical activity has been linked to a 28% reduction in HF hospitalizations and a 35% decrease in all-cause mortality in patients with HF. Exercise can reduce cardiomegaly and reverse left ventricular remodeling in patients with heart failure and reduced ejection fraction (HFrEF). HFrEF patients experience a notable increase in exercise capacity, leading to symptomatic improvement of up to 25%. Lifelong exercise is associated with a lower risk of HFrEF due to its inverse association with left ventricular stiffness. A 1 metabolic equivalent (MET) unit increase in cardiorespiratory fitness (CRF) achieved through regular exercise has been found to reduce the risk of HF by 17%.

Mortality: Sedentary individuals have a 20% to 30% higher risk of death from any cause compared to those who engage in 150 minutes of moderate-intensity exercise per week. Cohort analysis involving over 600,000 individuals revealed that low leisure-time PA levels, such as 75 minutes of brisk walking per week, can add 1.8 years to life expectancy, while 300 to 450 weekly minutes can add an average of 4.2 years compared to no PA. Additionally, individuals who transitioned from being non-exercisers to exercise maintainers experienced the largest decrease in all-cause mortality, highlighting the significant reduction in mortality risk associated with regular exercise.

Conclusion: The study emphasizes that physical inactivity and sedentary behavior are controllable risk factors for CVD and can predict poor cardiovascular health. Regular exercise induces physiological changes, such as exercise-induced cardiac remodeling and alterations in the vasculature, which improve cardiorespiratory fitness and reduce the risk of CVD and mortality. Physicians should prioritize discussions about physical activity with their patients and encourage regular exercise as a means to manage cardiovascular health and prevent CVD. Regular physical activity has been shown to significantly benefit glycemic control, blood pressure, lipid levels, and reduce the risk of HF, CAD, and all-cause mortality.