2006 Robert Levy Memorial Lecture—Physical Activity in the Prevention and Treatment of Cardiovascular Disease
Much of the evidence linking a sedentary way of life to cardiovascular disease (CVD) has been derived from relatively healthy populations, but there are data on the effects of physical activity in individuals with health problems or with risk factors for chronic disease. Clinicians, and often the general public, frequently consider the primary value of physical activity as the contribution it makes to control of these other risk factors. This approach underestimates the value of physical activity in the prevention and treatment of CVD. There is a steep inverse gradient of CVD and all-cause mortality across categories of cardiorespiratory fitness and physical activity in all subgroups—women and men who are middle-aged or older, obese or normal weight, or healthy or unhealthy. The overall death rates vary by these subgroups (older individuals obviously have higher death rates than younger persons), but the pattern of association of fitness or activity to mortality is comparable for the various population subgroups. In fact, fit individuals with another risk factor often have lower death rates than unfit individuals without the risk factor. Regular physical activity and moderate to high levels of cardiorespiratory fitness provide protection against CVD and all-cause mortality, and these items should be given increased attention by physicians and other healthcare professionals. These findings are supported by both observational studies and randomized trials.