There is a maxim among doctors who work and understand exercise and sport: the number one item on any medical prescription should be physical activity! This is because it is physical activity that effectively reduces mortality in patients with or without comorbidities. However, there are always unbelievers. For these, an article was published in February of this year, in the Journal of the American College of Cardiology (JACC), which ratifies the importance of physical activity over inactivity in patients with coronary heart disease.
Exercise reduces mortality risk for patients with cardiovascular disease — Photo: Istock Getty Images
Thus, patients with coronary heart disease (CAD) have an increased risk of mortality and regular physical activity is an important protective factor against cardiovascular disease and death. Several mechanisms are responsible for the benefits of physical activity in patients with cardiovascular disease, including:
- Improved endothelial function;
- Antiatherosclerotic effects;
- Anti-inflammatory effects.
This is nothing new and for years several studies have corroborated these findings and we have American and European guidelines recommending an active and healthy lifestyle.
However, some findings in this systematic review involving 33,576 patients with coronary heart disease are noteworthy. The article presents four patient trajectories: inactive and active over time, increased physical activity and decreased activity over time.
- The risk of mortality was 50% lower in patients who were always active compared to inactive patients;
- Mortality was 45% lower in those who were inactive but became active compared to those who were always inactive;
- Mortality was 20% lower in those who were active but became inactive, compared to those who were inactive.
These results indicate that:
- Active patients should be encouraged to maintain this lifestyle after coronary heart disease;
- Regardless of previous levels of physical activity, it is particularly important for patients to increase their levels of exercise over time after a diagnosis of CHD;
- Patients who have already had a heart attack or angioplasty can overcome previous years of inactivity and obtain survival benefits similar to those who remained active;
- However, the benefits of physical exercise can be attenuated or even lost if the activity is not maintained.
The data presented by the article creates a robust evidence base and provides new insights. It also draws attention to some important implications for clinical practice, since functional and habitual physical fitness assessments should be part of the investigation and prognosis processes of patients with heart disease.
Therefore, despite some limitations, the study points out some interesting news: the main one, and which may not be new for those who militate in this area, is that physical activity is the best medicine for anyone at any time.
* The information and opinions expressed in this text are the sole responsibility of the author, not necessarily corresponding to the point of view of ge / Eu Atleta.