Exercise and prevention

Series on Exercise in Cardiovascular Disease

Balady, Gary J. MD

Author Information

Associate Editor, Circulation

For more than a half century, exercise testing has remained a readily available and reliable clinical tool to evaluate patients with known or suspected cardiovascular disease. Yet, data continue to emerge regarding novel applications of this durable technology. Exercise, however, has taken on a new role in contemporary clinical cardiology for its therapeutic benefits in both the primary and secondary prevention of cardiovascular disease. While it has long been recognized that exercise and physical activity confer health, the data that support this observation are now robust and far-reaching. Understanding the mechanisms by which exercise yields its myriad of benefits has become a prolific area of research, the findings of which tell an interesting and evolving story that spans from molecular interactions to integrated physiological systems. Physical Activity and Cardiovascular Health: Lessons Learned From Epidemiological Studies Across Age, Gender, and Race/Ethnicity Shiroma, Eric J. MSc; Lee, I-Min MBBS, ScD Author Information From the Department of Epidemiology, Harvard School of Public Health (E.J.S., I.L.), and Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School (I.L.), Boston, Mass. Correspondence to I-Min Lee, MD, ScD, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave E, Boston, MA 02215. E-mail ilee@rics.bwh.harvard.edu In 1953, Morris et al 1,2 published the findings from a study showing that bus conductors in London, who spent their working hours walking the length of the buses as well as climbing up and down the stairs of the English double-decker buses to collect fares, experienced half the coronary heart disease (CHD) mortality rates of their driver counterparts, who spent their day sitting behind the wheel. Investigators hypothesized that it was the physical activity of work that protected the conductors from developing CHD, at the same time realizing that other factors may also play a role because the conductors were smaller in size, as evidenced by their smaller uniform sizes. Thus was born the field of “physical activity epidemiology”: formal epidemiological investigations into the associations of physical activity with many health outcomes./.../