Even small amounts of physical activity are associated with a lower risk of cardiovascular disease, but more exercise may lead to an even greater reduction in the risk of death from cardiovascular disease, according to a clinical perspective from the ACC Sports and Exercise Cardiology Leadership Council published Jan. 18 in the Journal of the American College of Cardiology.

According to the Council, most people in developed countries should not be concerned by potential harm from exercise but rather by too little exercise. While studies have shown that regular exercise reduces the risk of death from cardiovascular disease, only half of U.S. adults meet the federally-recommended guidelines of 150 minutes per week of moderate intensity exercise or 75 minutes per week of vigorous intensity exercise.

The Council examined recent research on the volume and intensity of aerobic exercise required for favorable cardiovascular health and found that moderate and vigorous intensity exercise in amounts lower than the 2008 Physical Activity Guideline recommendations still significantly lower mortality risk. They also found that there is no evidence for an upper limit to exercise-induced health benefits and all amounts of both moderate and vigorous intensity exercise result in a reduction of both all-cause and cardiovascular disease mortality compared to physical inactivity.

While controversial, a few limited studies have raised the concern that high volumes of aerobic exercise may be as bad for cardiovascular outcomes as no exercise at all. According to the Council, the possibility that too much exercise training could be harmful is worthy of investigation, but research shows that even for the very active, life-long endurance athletes, the benefits of exercise training outweigh the risks.

“The public media has embraced the idea that exercise may harm the heart and disseminated this message, thereby diverting attention away from the benefits of exercise as a potent intervention for the primary and secondary prevention of heart disease,” says Michael Scott Emery, MD, FACC, co-chair of the ACC Sports and Exercise Cardiology Council. “The available evidence should prompt clinicians to recommend strongly low and moderate exercise training for the majority of our patients. Equally important are initiatives to promote population health at large through physical activity across the life span, as it modulates behavior from childhood into adult life.”

Keywords: Athletes, Cardiovascular Diseases, Exercise, Heart Diseases, Secondary Prevention, Sports

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