How to Implement Physical Activity in Primary and Secondary Prevention
A Statement for Healthcare Professionals From the Task Force on Risk Reduction, American Heart Association
Substantial data exist on the benefits of physical activity in both primary and secondary prevention of cardiovascular disease. These data are well documented in American Heart Association position statements,1 2 the current Surgeon General’s report,3 and population studies.4 5 6 7 8
The purpose of this “how-to” statement is to delineate the fundamentals of implementation of physical activity in both primary and secondary prevention of cardiovascular disease. The recommendations and rationale of earlier scientific statements1 2 on exercise have been translated into practical suggestions that can be implemented in the physician’s office.
Physical activity in primary prevention should begin in the early school years and continue throughout an individual’s lifetime. Schools must specifically designate physical education programs with aerobic activities for children at early ages. Programs should include recreational sports such as running, dancing, swimming, and selected types of resistance exercises using free weights and/or specific equipment. There also should be support for an active lifestyle for children at home.
In the patient-visit setting, physicians and their staff should discuss physical activity and provide exercise prescriptions for patients and their families. In some instances, suggestions could be made about implementing physical activity recommendations at the worksite.
Intensity, duration, and frequency as well as mode and progression should be considered in all types of physical activity programs. As children and adolescents become adults and discontinue the athletic endeavors of school and college, primary prevention must include a plan for a lifetime of appropriate physical activity. Ideally this activity should be done for at least 30 to 60 minutes four to six times weekly1 or 30 minutes on most days of the week.3 The frequency, duration, and intensity of the activity should be individualized to personal satisfaction as well as mode and progression. Subjects may use …