What level of physical activity is helpful?

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Who is most beneficial in terms of cardiovascular disease risk? A new study is investigating. Image Credit: Kristian Buus / In Pictures via Getty Images
  • Cardiovascular disease is an umbrella term for disorders that affect either the heart, blood vessels, or both.
  • Moderate to vigorous physical activity has many benefits, but it may be most helpful for people who already have cardiovascular disease.
  • The physical activity that individuals engage in in their spare time can provide the highest level of health benefits.

Cardiovascular disease, or any disorder that affects the heart or blood vessels, is very common and serious. Experts believe that almost half of all American adults have some form of cardiovascular disease.

A recent study published in PLOS Medicinehave found that people with cardiovascular disease can benefit greatly from physical activity.

However, in healthy individuals, there comes a time when increasing the level of physical exercise does not provide additional health benefits.

But the researchers in this study found that the benefits of physical activity did not reach a similar plateau in participants with cardiovascular disease.

Cardiovascular disease (CVD) is a broad term. As the National Institutes of Health (NIH) Note, cardiovascular disease is any disease that affects the heart or blood vessels, while heart disease includes disorders that specifically affect the heart.

Several disorders fall under the category of CVD, including:

Treatments for CVD may vary. Depending on the severity of the problem, people with CVD may need to take medication or have surgery.

Several risk factors increase a person’s risk of getting CVD. For example, the Centers for Disease Control and Prevention (CDC) note that high blood pressure, high cholesterol, or diabetes increase the risk of heart disease.

People can modify certain risk factors to help prevent the adverse health effects of cardiovascular disease.

Experts are still discovering how people can best prevent cardiovascular disease and reduce their overall risk of death. Physical activity has been the subject of many studies, and experts are still learning who benefits the most.

The study in question was a cohort study conducted by researchers in the Netherlands. It included a total of 142,493 participants. The team wanted to know if people’s cardiovascular health had an impact on the overall benefit of physical activity.

In other words, is physical activity useful for everyone at the same level or does it help more those who already have CVD?

The researchers also wanted to know if the reason for the physical activity had an impact on the benefits. For example, do people who need to be physically active for a job get the same benefits as those who are physically active in their free time?

Because there are so many risk factors and CVD includes so many disorders, the researchers in this study had to define their terms carefully.

They looked at three broad groups of people and used the following definitions:

  • Healthy individuals: These participants had all cardiovascular risk factors within a normal range and reported no known cardiovascular disease.
  • People with at least one risk factor for CVD: These participants either had self-reported high blood pressure, high cholesterol and / or diabetes, along with medications to control the respective risk factors, or had confirmed high cholesterol or blood sugar, and no disease. cardiovascular disease reported.
  • People with CVD: These people had a history of heart failure, heart attack or stroke and were using drugs for these conditions.

Each participant completed a basic questionnaire and underwent a physical exam. The questionnaire included information on lifestyle, medical history and diet. The researchers collected baseline data from each participant and followed it up an average of 6.8 years later after collecting the baseline data.

The team then asked participants about their level of physical activity. This information determined how much of each participant’s exercise met the study definition of moderate to vigorous.

They also divided the types of physical activity into three categories:

  1. Recreational physical activity was all moderate to vigorous physical activity that participants engaged in in their free time.
  2. Non-recreational physical activity was all moderate to vigorous physical activity that people did not engage in in their leisure time, such as work or housework.
  3. Work-related physical activity was all moderate to vigorous physical activity that participants engaged in in relation to work. This was a sub-category of non-recreational physical activity.

The team examined the relationship between moderate to vigorous physical activity, all causes of death, and major adverse cardiovascular events. They included heart attacks, strokes, chronic and acute heart failure, and all major heart or thoracic surgeries, such as heart transplants and bypass surgery, in their analysis of major adverse cardiovascular events.

The researchers found that overall, moderate to vigorous physical activity was associated with reduced all-cause mortality and major adverse cardiovascular events. But they also found that it was most beneficial for the group of participants who already had CVD.

The study’s first author, Dr Esmée Bakker, explained to Medical News Today that “for healthy people and those with cardiovascular risk factors, such as hypertension and diabetes, we have found that increasing exercise volumes results in a gradual reduction in risk to a point where a plateau occurs “.

Dr Bakker went on to explain that this result was different for participants who already had CVD:

“However, patients with cardiovascular disease exhibited a different pattern, with each increase in the volume of physical activity resulting in a further reduction in the risk of mortality and cardiovascular events. This result highlights that more exercise is better for [CVD] the patients.”

The researchers also found that moderate to vigorous physical activity performed by participants in their free time was associated with the highest level of health benefits. Moderate to vigorous physical activity outside of leisure time was associated with some health benefits, and moderate to vigorous occupational physical activity was associated with no benefit.

Overall, the researchers concluded that physical activity recommendations should take into account cardiovascular health status and the nature of the physical activity (leisure or non-leisure).

However, the study had some limitations. First of all, the research was observational, which means it cannot prove that higher physical activity prevents mortality or adverse cardiovascular events. Second, some of the data has been self-reported, which presents the risk of inaccurate data collection.

Dr Edo Paz, cardiology specialist VP of Medical at K Health, noted the following study limitations to MNT:

“First of all, the activity level is self-reported, which may be inaccurate. Another key limitation of this study is that it is an observational study and therefore limited by confusion. This means that exercise can be strongly correlated with another factor (like weight, nutritional status, etc.), and it is in fact this other factor that predicts cardiovascular events. Although the authors have tried to account for these confounding factors, it is not possible to collect or control all of them.

Finally, the authors did not examine the impact of light-intensity physical activity – the study specifically looked at moderate to vigorous physical activity.

The researchers note that other studies have looked at why it is better to do some physical activity than not to do any. They note that starting with lower levels of physical activity may help some people increase their level of regular physical activity.

It’s also important to remember that everyone is different and different levels of physical activity will be different for different people.

Dr Paz said MNT: “It seems clear that physical activity is an important part of a healthy lifestyle, which is why the American Heart Association (AHA) recommends doing 150 minutes per week of moderate or moderate-intensity aerobic activity. 75 minutes per week of vigorous aerobic activity. However, this study indicates that these recommendations still need to be personalized.

Overall, the results indicate that physical activity recommendations should take into account a person’s cardiovascular health.

Dr Bakker explained that “[o]The results of this study are useful in further optimizing physical activity recommendations taking into account cardiovascular health status so that each individual, regardless of their cardiovascular health status, can optimally benefit from a fitness mode. physically active life.

Further research would include examining how to implement the best exercise plans for people with CVD.

Cardiologist Prof. Bernard Cheung – Sun Chieh Yeh Heart Foundation professor of cardiovascular therapy at the University of Hong Kong School of Medicine – explained to MNT this “[c]Caution should be exercised before getting patients with cardiovascular disease to exercise to their limits […] More research is needed on the exercise programs best suited for patients with different forms of cardiovascular disease (eg, angina, heart failure).

“This study underscores the importance of evidence-based recommendations in this area,” he noted.

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