Preventive Medicine


Several weeks ago, I wrote a blog about the American Heart Association’s (AHA) new guidelines for exercise for the prevention of high blood pressure. The AHA recommended teens and young adults exercise 20-25 minutes each day or a total of 150 minutes a week to reduce the incidence of hypertension.

Now, the AHA has come out and also recommended physical activity as first-line treatment for patients with elevated cholesterol levels. “The first treatment strategy for many of these patients should be healthy lifestyle changes beginning with increasing physical activity.”

An estimated 28% of U.S. adults have an LDL-Cholesterol above 70 mg/dL and are also  blessed with low risk factors for cardiovascular disease. It is these folks for whom vigorous exercise and lifestyle changes (rather than drug treatment) are the first recommendation to consider. “Physical activity was associated with a 21% lower risk of developing cardiovascular disease and a 36% lower risk of death from cardiovascular causes.” That means, in this cohort of individuals, exercise lowers the risk of dying from heart-related diseases by over one-third.

The U.S. Department of Health and Human Services, as far back as 2018, recommended 150 minutes of moderate-intensity aerobic exercise, or 75 minutes of vigorous aerobic activity weekly plus two or more strength training sessions each week. 

As exercise is “increasingly engineered out of our lives and the overwhelming default is to sit….the message to ‘sit less and move more’ throughout the day is more important than ever.”

Cholesterol and blood pressure, two major risk factor for cardiovascular disease, are definitely impacted positively by this aggressive exercise program. Intellectually, we have accepted the importance of exercise for decades, but getting patients to comply has been a constant challenge. Intentions start out good, but then something interrupts the routine and people let it slide or quit altogether. Excuses for quitting are numerous. Those patients who do remain committed always see benefits from exercise, even if it’s only weight loss. 

Dr. G’s Opinion: This article once again underlines the value of exercise. We all know we should do it, but many, actually most, don’t. Factual information about exercise is everywhere, and data about the many benefits can be found easily. Knowing the benefits should be an incentive, but personal responsibility has to be ingrained in the individual or nothing will change. At least some success has been achieved in smoking cessation, and people are aware of the harms of high blood pressure and cholesterol so inroads have been made. Getting people to exercise 150 minutes a week is much harder than getting them take a few pills. If exercise came in pill form, “what a wonderful world this would be!”


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