Physical inactivity is a major risk factor for coronary artery disease, a leading cause of death according to American Heart Association (AHA). In addition, sedentary lifestyle increases the risk of other diseases including stroke, diabetes, high blood pressure, obesity, depression, anxiety and many more. By exercising you can prevent or postpone the onset of heart disease and some other illnesses including colon cancer, type 2 diabetes, osteoporosis, high blood pressure, dementia, rheumatoid arthritis, anxiety, depression, obesity, back pain and disability. Exercise can improve other modifiable risk factors for coronary heart disease, vascular diseases and stroke including high blood pressure, type 2 diabetes, high cholesterol, and obesity. In addition to quitting smoking, exercise is the most effective way to protect against heart disease.

 

In the United States, an estimated one out of ten premature deaths is due to physical inactivity. As many as 250, 000 deaths per year in the US are attributable to a lack of regular physical activity. Despite knowing the risks of inactivity, many Americans are still sedentary and only one-third of Americans meets the minimal recommendations for physical activity as outlined by the CDC, the ACSM, and the AHA expert panels. Over 60% of American adults are not regularly active, and 25% of the adult population is not active at all.

 

Regardless of age, everyone benefits from regular exercise. Regular exercise increases longevity and slows the aging process. There is a higher rate of cardiovascular events and a higher death rate in individuals with low levels of physical fitness. Healthy adults who are the least fit have a mortality risk that is 4.5 times that of the most fit. An individual’s fitness level is a more important predictor of death than cardiac risk factors such as smoking, high blood pressure, high cholesterol, and diabetes. The protective effects on the heart are mediated through a reduction in blood pressure (1/3), reduction of “bad” cholesterol while increasing “good” cholesterol (1/3).

 

With regular exercise the heart muscle becomes stronger and more efficient. There is a direct relationship between exercise and health benefits –, the more you exercise, the more health benefits you gain. The greatest gains in terms of mortality are achieved when an individual goes from being sedentary to becoming moderately active. Patients with a history of heart attack who participated in a formal exercise program reduced their death rate by 20% to 25%. If coronary heart disease develops in active or fit individuals, it seems to occur at a later age and tends to be less severe. Regular aerobic exercise strengthens the immune system and improves the outcome of some autoimmune diseases.

 

Any exercise is better than no exercise. The most important thing is to start! A couple easy things to do are to- take stairs instead of an elevator, or park your car farther away from your destination- to get yourself moving. Most health benefits are gained by moderate intensity, aerobic exercise like brisk walking at a rate of 3 – 4 miles/hr, gardening, swimming, golfing, dancing, jogging, etc., 3-4 sessions a week, 40 minutes per session at moderate-to-vigorous intensity physical activity. Daily exercise sessions could also be divided into 10 minute-sessions. If most Americans met these minimal exercise requirements, this would decrease cardiovascular events by 30% to 40%. Young people aged 6-17 years need at least one hour of physical activity every day.

 

Stretching should be incorporated into an overall fitness regimen. It increases tendon flexibility, improves joint range of motion (ROM) and function, and enhances muscular performance. Resistance exercise can be combined with aerobic endurance exercise for additional health benefits. Proper preliminary screening, and careful supervision are very important for cardiac patients. If you have a chronic condition or illness like osteoarthritis/rheumatoid arthritis preventing you from a regular exercise, it is important that you discuss other exercise options with your doctor. Your doctor will be able to advise you on the best type of exercise given your chronic illness in order to avoid injury during exercise.

 

If you have been sedentary, are older than 45 years of age, and have 2 or more risk factors (family history of heart disease, smoking, high blood pressure, abnormal cholesterol, diabetes, or obesity), you should consult your physician before starting any type of exercise regimen. Be aware of symptoms such as chest/jaw/arm discomfort, shortness of breath, lightheadedness/dizziness or palpitations associated with exercise, and promptly report these to your doctor. You may need to undergo a supervised exercise test, in order to screen for any possible adverse effects of exercise. Regular physical activity is accessible and affordable to all people and should be combined with other lifestyle modifications such as healthy diet, weight reduction, smoking cessation, and medical therapies.

 

1. AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk JACC S735-1096. 2013.
2. Pate RR, Pratt MP, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA,. 1995; 273: 402–407.
3. American College of Sports Medicine. Guidelines for Exercise Testing and Prescription. 6th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2000.
4. Paffenbarger RS, Hyde RT, Wing AL, et al. The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Eng J Med. 1993; 328: 538–545.
5. Department of Health and Human Services (US). Physical activity guidelines for Americans. Washington: HSS; 2008.
6. American College of Sports Medicine position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30:975–991.