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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:1319.)
© 2003 American Heart Association, Inc.

Editorials

Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease

Paul D. Thompson

Department of Preventive Cardiology and Cardiovascular Research, Division of Cardiology, Hartford Hospital, and Department of Medicine, University of Connecticut, Farmington, Conn.

Correspondence to Paul D. Thompson, MD, Cardiology, Hartford Hospital, 80 Seymour St, Hartford, CT 06102. E-mail pthomps@harthosp.org

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Dr Paul Dudley White, the Boston cardiologist famous for consulting on President Eisenhower when Eisenhower suffered a myocardial infarction in 1955, believed that "a normal person should exercise seven hours a week. If you could not exercise an hour everyday, make up the difference on the weekend."¹ So familiar was White’s advocacy of exercise that his obituary in the New England Journal of Medicine started with the statement, "Practically everyone knows that Dr Paul Dudley White rode a bicycle and preached exercise."²

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Cardiovascular preventive and therapeutic treatments have advanced remarkably since White’s death in 1973, but a recently released Scientific Statement from the American Heart Association Counsels of Clinical Cardiology and Nutrition, Physical Activity and Metabolism³ emphasizes that exercise remains a valuable therapeutic strategy for patients with, or at risk for, atherosclerotic cardiovascular disease. Whenever possible, the Statement’s conclusions and recommendations were based on summary articles and meta-analyses. This editorial reviews the salient recommendations and their supporting evidence from that Statement.

The Statement summarizes strong epidemiologic evidence that physical activity reduces the incidence of atherosclerotic heart disease. In addition, exercise is useful in managing several atherosclerotic risk factors. A meta-analysis of 52 exercise training trials lasting >12 weeks including 4700 subjects demonstrated an average increase in HDL-C levels of 4.6% and reductions in triglycerides and LDL-C concentrations of 3.7% and 5.0%, respectively.^4,5 Such results suggest that exercise serves primarily as adjunctive therapy for most patients with lipid disorders, although some individuals experience greater lipid effects, and few . . . [Full Text of this Article]

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