It may not prevent heart disease, but exercise's still good

ON CALL

June 01, 1993|By Dr. Simeon Margolis | Dr. Simeon Margolis,Contributing Writer

My cholesterol and blood pressure are normal and I don't smoke, but I have a desk job and get no regular exercise. How important is exercise for the prevention of a heart attack?

Two studies reported in a recent New England Journal of Medicine addressed this issue. One provided evidence that regular exercise during leisure time protected men from dying of heart disease, as well as other causes. The second found that men who were more physically fit had a lower risk of dying from any cardiovascular disease. These results support those of at least 25 other studies which concluded that regular physical activity helps to prevent a first heart attack. The American Heart Association has now added physical inactivity to the list of risk factors for coronary artery disease.

Nonetheless, the role of exercise in preventing heart disease remains controversial because the studies only show an association between exercise and reduced heart disease, not that the exercise is the cause of the lowered risk. The studies can't rule out the possibility that other differences between exercisers and couch potatoes are responsible for the apparent benefits of exercise.

Despite these doubts about its impact on heart disease, regular exercise has many advantages. It helps to control weight, raises HDL cholesterol levels, improves work capacity and is a valuable release.

Since you have been habitually inactive, you should not start a rigorous exercise program without checking with your doctor, particularly if you are over age 50 or have had any symptoms upon exertion. Many feel they must run or engage in strenuous physical activity. In fact, adding a regular brisk walk can be a healthful form of exercise. Begin gradually, avoid over-exertion and see a doctor promptly should you develop symptoms while exercising.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

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