Over the last 40 years, many studies have been done to look into the links between exercise, fitness, and heart health. The US Surgeon General’s Report on Physical Activity and Health, which came out in 1996, and subsequent expert panels put together by the CDC, the American College of Sports Medicine, and the American Heart Association all confirmed that there is strong scientific evidence linking regular physical activity to different measures of cardiovascular health. The results of these studies showed that people who are physically busy or fit are less likely to get coronary heart disease (CHD). CHD usually shows up later in life and has less of an effect on people who are physically fit and busy.
Up to 250,000 Americans may die each year because they don’t move around enough. Regular physical exercise has been shown to help people with non-heart diseases like diabetes that don’t need insulin, high blood pressure, osteoporosis, and colon cancer. On the other hand, people who aren’t physically active are more likely to get heart disease and die. Getting more physically active at any age, whether for work or fun, is linked to a lower chance of dying.5 Even with all this proof, most Americans still don’t get enough exercise. Only about a third of the country’s adults meet the minimum activity standards set by the CDC, ACSM, and American Heart Association.
What Are the Benefits of Exercise?
A sedentary lifestyle is one of the 5 major risk factors (along with high blood pressure, abnormal values for blood lipids, smoking, and obesity) for cardiovascular disease, as outlined by the AHA.
Evidence from many scientific studies shows that reducing these risk factors decreases the chance of having a heart attack or experiencing another cardiac event, such as a stroke, and reduces the possibility of needing a coronary revascularization procedure (bypass surgery or coronary angioplasty).
Regular exercise has a favorable effect on many of the established risk factors for cardiovascular disease. For example, exercise promotes weight reduction and can help reduce blood pressure. Exercise can reduce “bad” cholesterol levels in the blood (the low-density lipoprotein [LDL] level), as well as total cholesterol, and can raise the “good” cholesterol (the high-density lipoprotein level [HDL]).
In diabetic patients, regular activity favorably affects the body’s ability to use insulin to control glucose levels in the blood.
Although the effect of an exercise program on any single risk factor may generally be small, the effect of continued, moderate exercise on overall cardiovascular risk, when combined with other lifestyle modifications (such as proper nutrition, smoking cessation, and medication use), can be dramatic.
Benefits of Regular Exercise on Cardiovascular Risk Factors
- Increase in exercise tolerance
- Reduction in body weight
- Reduction in blood pressure
- Reduction in bad (LDL and total) cholesterol
- Increase in good (HDL) cholesterol
- Increase in insulin sensitivity
There are several physiological benefits of exercise; examples are improvements in muscular function and strength and improvement in the body’s ability to take in and use oxygen (maximal oxygen consumption or aerobic capacity).
As one’s ability to transport and use oxygen improves, regular daily activities can be performed with less fatigue.
This is particularly important for patients with cardiovascular disease, whose exercise capacity is typically lower than that of healthy individuals.
There is also evidence that exercise training improves the capacity of the blood vessels to dilate in response to exercise or hormones, consistent with better vascular wall function and an improved ability to provide oxygen to the muscles during exercise.
Studies measuring muscular strength and flexibility before and after exercise programs suggest that there are improvements in bone health and ability to perform daily activities, as well as a lower likelihood of developing back pain and disability, particularly in older age groups.
Patients with newly diagnosed heart disease who participate in an exercise program report an earlier return to work and improvements in other measures of quality of life, such as more self-confidence, lower stress, and less anxiety.
Importantly, by combining controlled studies, researchers have found that for heart attack patients who participated in a formal exercise program, the death rate is reduced by 20% to 25%.
This is strong evidence in support of physical activity for patients with heart disease.
Although the benefits of exercise are unquestionable, it should be noted that exercise programs alone for patients with heart disease have not convincingly shown improvement in the heart’s pumping ability or the diameter of the coronary vessels that supply oxygen to the heart muscle.