Exercise and physical activity are of vast global importance to prevent and control the increasing problem of cardiovascular disease and stroke, according to a review paper published Sept. 24 in the Journal of the American College of Cardiology.

Physical inactivity is considered one of the leading modifiable risk factors for cardiovascular disease, along with smoking status and high low-density lipoprotein (LDL) cholesterol levels. In a systematic review, Gerald F. Fletcher, MD, FACC, et al., compiled the results of 25 published reviews that addressed both personal and environmental variables related to physical activity to determine how health care professionals can empower patients to adhere to a heart-healthy lifestyle.

The authors explain that current guidelines recommend at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week. Aerobic exercise has been shown to lower systolic and diastolic blood pressure as much as 15 and 9 mmHg, respectively, among hypertensive patients, as well as reduce ischemic stroke risk and decrease LDL levels with the aid of a proper diet.  

Sedentary behaviors occupy almost eight hours of the average person’s day but replacing one hour of sitting time with an equal amount of activity has been shown to effectively lower all-cause mortality. Moving forward, the researchers recommend incorporating more daily lifestyle activities into the day, such as yard work, household chores, or walking/biking to and from work. They also list stand-up desks, stand-up conference rooms with no chairs and using the stairs instead of an elevator as a few of the ways a work environment can promote physical activity for its employees.

According to the review, both inpatient and outpatient cardiac rehabilitation have also been shown to successfully reduce all-cause mortality and empower cardiovascular disease patients to combat modifiable cardiac risk factors. The success of these preventive programs heavily relies on the patient’s commitment to changing sedentary behaviors and consistent follow-up from the patient’s health care provider. 

“Just like medication, the right form of physical activity has to be specialized for each patient. Physical activity is no different from smoking cessation or eating a heart-healthy diet,” said Fletcher. “It is up to health care professionals to set an example for their patients in all aspects of life.”

This paper is the seventh in an eight-part cardiovascular health promotion JACC focus seminar, where each paper focuses on a different behavioral consideration that impacts cardiovascular health: nutrition and diet; tobacco-free lifestyle; cholesterol; blood pressure; psychological health; healthy weight; exercise and physical activity and blood sugar.

Keywords: Risk Factors, Blood Pressure, Elevators and Escalators, Cardiac Rehabilitation, Blood Glucose, Tobacco, Cholesterol, LDL, Walking, Smoking Cessation, Inpatients, Outpatients, Sedentary Behavior, Brain Ischemia, Follow-Up Studies, Stroke, Exercise, Health Promotion, Life Style, Eating, Smoking

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