What are the benefits of exercise on cardiovascular health?

By Bhavana KunkalikarReviewed by Lily Ramsey, LLMMay 1 2023

In a recent study published in the Progress in Cardiovascular Diseases Journal, researchers estimated the impact of exercise on cardiovascular (CV) health.

Study: Exercise and cardiovascular health: A state-of-the-art review. Image Credit: GoodStudio/Shutterstock.com

Background

Numerous studies have proven regular exercise over several decades to be an effective primary and secondary protection against various health issues such as cardiovascular disease (CVDs), hypertension, obesity, diabetes, and premature mortality.

Even small increases in regular physical activity (PA) can lead to significant risk reduction, making it an important aspect of population health. Both resistance and aerobic exercise training can significantly reduce the risk of CVD, even if the recommended exercise guidelines are unmet.

Effects and advantages of exercise on CVD

Diabetes Mellitus (DM)

Resistance and aerobic exercises can improve glycemic control, enhance insulin response, reduce adipose tissue, especially visceral abdominal fat, and promote weight loss in patients with prediabetes and DM2. Exercise can protect against metabolic syndrome and may be used as a therapy for patients with DM2, resulting in a lower CVD burden.

Resistance and aerobic training improve glycemic control by enhancing insulin sensitization and activity in peripheral tissues, particularly in adipose tissue, skeletal muscle, and the liver. The greatest enhancements are seen in patients with higher baseline insulin resistance and those who exercise more.

Hypertension (HTN)

Aerobic exercise and resistance training, both isotonic and isometric, are effective in reducing blood pressure, in addition to the recommended Dietary Approaches to Stop Hypertension (DASH) diet.

Moderate to high-intensity resistance training and aerobic exercise can reduce systolic and diastolic blood pressure by two to five mm Hg in normotensive individuals and five to seven mm Hg in individuals with HTN. The effects, however, depend on PA's duration, frequency, and intensity.

Habitual aerobic exercise leads to decreased resting blood pressure due to various mechanisms such as decreased sympathetic activity, reduced vascular wall thickness, and arterial dilation resulting in a reduction in peripheral vascular resistance.

During exercise, the body requires more blood flow to the skeletal muscle. This is achieved through increased activity in the sympathetic nervous system, resulting in higher myocardial contractility and heart rate.

Coronary artery disease (CAD)

Regular exercise can help reduce the risk factors associated with coronary artery disease (CAD), such as hyperlipidemia and HTN. Additionally, exercise can improve coronary arterial function, slowing the development and progression of CAD.

Research indicates that exercising moderately for five to six hours per week can lead to a reduction in coronary plaques. Additionally, combining exercise with optimal medical therapy is comparable to percutaneous coronary intervention (PCI) for patients with small ischemia areas.

Heart failure

PA has been associated with a 28% reduction in heart failure (HF) hospitalizations and a 35% decrease in all-cause mortality in patients with HF. PA can reduc e cardiomegaly and reverse left ventricular remodeling in heart failure patients with reduced ejection fraction (HfrEF).

HFrEF patients experience a notable increase in exercise capacity, resulting in a symptomatic improvement of up to 25%. Lifelong exercise is linked to a lower risk of HFrEF due to its inverse association with LV stiffness.

Regular exercise leading to an elevation of 1 metabolic equivalent (MET) unit in cardiorespiratory fitness (CRF) has been found to reduce the risk of HF by 17%.

Mortality

Sedentary people have a 20% to 30% higher risk of death from any cause than people who exercise 150 minutes per week at a moderate intensity.

According to a cohort analysis involving more than 600,000 people, low leisure-time PA levels, such as 75 minutes of brisk walking per week, add 1.8 years to life expectancy, whereas 300 to 450 weekly minutes add an average of 4.2 years, as compared to no PA.

Additionally, patients who switched from non-exercisers to exercise maintainers experienced the largest decrease in all-cause mortality, demonstrating that regular exercise offers the best decrease in all-cause mortality concerning PA.

Conclusion

The study findings showed that PI/SB is a controllable risk factor for CVD and can predict poor cardiovascular health. Regular exercise can lead to physiological changes such as exercise-induced cardiac remodeling and alterations in the vasculature. These changes can improve cardiorespiratory fitness and reduce the risk of CVD and mortality, making them crucial for maintaining CV health.

Regular physical activity has been shown to significantly benefit glycemic control, blood pressure, and lipid levels. It lowers the chances of HF, CAD, and all-cause mortality.

Physicians should prioritize discussions about physical activity with their patients and encourage regular exercise to manage cardiovascular health and prevent CVD.