Moderate to Vigorous Physical Activity in Cardiovascular Disease

Regular physical (PA) activity is strongly associated with risk reductions of noncommunicable diseases and mortality. The 2020 World Health Organization Physical Activity Guidelines recommend adults to perform at least 150 minutes/week of moderate intensity PA, or 75 minutes/week of vigorous intensity PA, or an equivalent combination of the 2. 

Data from the general population indicate that the benefits of PA on mortality and morbid- ity follow a curvilinear dose–response relationship, indicating that low or moderate volumes of PA yield a large risk reduction, whereas further increases in exercise volumes pro- duce smaller additional benefits.

Study on Physical Activity and Cardiovascular Disease

A recently published study in the journal PLoS Medicine and conducted in the Netherlands. Conducted a cohort study with a total of 142,493 participants. The research team evaluated people’s cardiovascular health status and how it impacted the overall benefit of physical activity. 

Moderate to vigorous physical activity (MVPA) is strongly associated with risk reductions in cardiovascular diseases and mortality. The researchers compared the association between MVPA and incident major adverse cardiovascular events (MACE) and mortality between healthy individuals, individuals with elevated levels of cardiovascular risk factors (CVRF) and cardiovascular disease (CVD).

They divided the participants in these 3 groups: 

• Healthy individuals. All cardiovascular risk factors in normal range and no known reported CVD.
• Individuals with at least one CVD risk factor. These participants had either high blood pressure, high cholesterol and/or diabetes, and no reported CVD.
• Individuals with CVD. Participants with a history of heart failure, heart attack or stroke and that used medications to control these conditions. 

Each participant did a questionnaire at baseline (diet, lifestyle, health history) and had a physical exam. They were followed up for an average of 6.8 years. 

They also divided types of physical activity into three categories:

1. Leisure physical activity was all the moderate-to-vigorous physical activity that participants did during their leisure time.
2. Nonleisure physical activity was all the moderate-to-vigorous physical activity that people did not do in their leisure time, such as during work or household chores.
3. Occupational physical activity was all the moderate-to-vigorous physical activity that participants did related to work. This was a subcategory of nonleisure physical activity.

The research team evaluated the relationship between moderate-to-vigorous physical activity, causes of death and major adverse cardiovascular events.

They found that overall, moderate-to-vigorous physical activity had links to lower all-cause mortality and major adverse cardiovascular events and that it was also most beneficial to the group of participants that already had CVD. 

Researchers also found that moderate-to-vigorous physical activity that participants did in their leisure time was associated with the highest level of health benefits. Nonleisure moderate-to-vigorous physical activity was associated with some health benefits, and occupational moderate-to-vigorous physical activity was associated with no benefits.

Individuals with cardiovascular diseases should be encouraged that “more is better” regarding physical activity. 

Sources: 

Esmée A. Bakker, et al. (2021) “Dose–response association between moderate to vigorous physical activity and incident morbidity and mortality for individuals with a different cardiovascular health status: A cohort study among 142,493 adults from the Netherlands.” PLoS Med 18(12): e1003845.
https://doi.org/ 10.1371/journal.pmed.1003845

Jessica Norris (2021, Dec 2). Cardiovascular disease: Is more exercise better? Medical News Today. Retrieved from:
https://www.medicalnewstoday.com/articles/cardiovascular-disease-is-more-exercise-better 

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https://www.newsweek.com/how-exercise-can-help-you-reach-next-level-your-career-1627563