Exercise

Exercise can reduce the risk of major illnesses, such as heart disease, stroke, diabetes and cancer by up to 50% and lower your risk of early death by up to 30% (1)

Exercise in patients without pre-existing coronary artery disease:

• a cohort study of participants in the Aerobics Center Longitudinal Study has revealed that men who maintained or improved adequate physical fitness had a reduced risk for all-cause and cardiovascular mortality in comparison with men who were persistently unfit. The criteria that the authors used to define 'fit' and 'unfit' are to be found in the study (2)
• the National Service Framework on Coronary Heart Disease recommends that adults should undertake 30 minutes of moderate intensity activity (such as brisk walking, cycling or heavy house work) on at least 5 days per week (3)
• NICE state that (4):
  • people at high risk of or with CVD should be advised to take 30 minutes of physical activity a day, of at least moderate intensity, at least 5 days a week, in line with national guidance for the general population
  • people who are unable to perform moderate-intensity physical activity at least 5 days a week because of comorbidity, medical conditions or personal circumstances should be encouraged to exercise at their maximum safe capacity
  • recommended types of physical activity include those that can be incorporated into everyday life, such as brisk walking, using stairs and cycling
  • people should be advised that bouts of physical activity of 10 minutes or more accumulated throughout the day are as effective as longer sessions

Exercise based cardiac rehabilitation in patients with existing coronary heart disease:

• there is evidence that exercise based cardiac rehabilitation reduces all cause and cardiac mortality and improves a number of cardiac risk factors (4)
• increased physical activity and combined dietary changes reduce mortality in coronary heart disease (5,6)

Reference:

• (1) NHS Choices (Accessed 10/5/14). Benefits of exercise.
• (2) Blair SN et al (1995), Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men, JAMA; 273: 1093-8.
• (3) Health Development Agency. Coronary heart disease. Guidance for implementing the preventive aspects of the National Service Framework. London 2000.
• (4) NICE (May 2008).Lipid modification - Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
• (5) Taylor RS et al (2004). Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med;116:682-92
• (6) Iestra JA et al. Effect size estimates of lifestyle and dietary canges on all-cause mortality in coronary artery disease patients: a systematic review. Circulation 2005;112:924-34.