Keep exercising, say heart experts
If you were about to put your feet up after hearing the latest rumours that exercise is bad for you, think again. A new clinical perspective from the Journal of the American College of Cardiology confirms that most people in developed countries should be more concerned with the lack of exercise in their lives than by the potential harm exercise can cause.
There is ample evidence that regular physical activity reduces the risk of death from cardiovascular disease (CVD). As obesity and related morbidity spiral out of control, participation in athletics and endurance sports has approximately doubled in the last 10 years. In 2012-2013, 7.7 million students participated in high school programmes, and in 2014, there was a record number of nearly 42 million American runners and joggers.
Endurance sports draw older athletes, with a record 47% of marathon finishers aged 40 years or over in 2013. It can end in disaster, however. One study reports a 0.75 fatality rate per 100,000 marathon finishers in the period 2000-2009. These were 28 people, 6 women and 22 men, with a median age of 41.5 years, half of them under 45 years. Myocardial infarction/atherosclerotic heart disease caused 93% of deaths in those 45 years and older, and the most common cause overall was cardiac arrest.
Worrying, maybe, but marathon running is a far cry from federal guidelines recommending that most people should exercise for 150 minutes per week at moderate intensity or vigorously for 75 minutes per week, a target that only half of Americans meet.
Mortality risk in different populations is significantly reduced by moderate and vigorous intensity exercise, even in amounts lower than those recommended by the 2008 Physical Activity Guideline. Higher levels of moderate-intensity exercise reduces CVD mortality.
For CVD patients, exercise can save lives, but one study showed that only 62% of heart attack patients were referred to cardiac rehabilitation when discharged from the hospital. Of those, just 23% attended more than one rehab session and only 5.4% completed more than 36 sessions.
Emery hopes that clinicians will be prompted to recommend low and moderate exercise training for most patients.
He also calls for initiatives to promote public health through exercise for all ages, because physical activity modulates behaviour from childhood into adulthood.
Dr. Valentin Fuster, PhD, editor-in-chief of JACC comments, The greatest benefit is to simply exercise, regardless of the intensity, while the danger is twofold: to not exercise at all or to exercise intensely without due preparation.
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