Exercise for Cardiovascular Disease Prevention and Treatment From Molecular to Clinical, Part 1

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5 Summary and Conclusions

The Table 1.1 presents evidence statements based on a summary of the evidence

given in this chapter. The evidence is such that exercise has been described as

today’s best buy in public health [ 91 ]. It’s time to take physical inactivity seriously

and we agree with those who would have policies to increase both physical activity

and cardiorespiratory fitness [ 43 , 48 ].

Acknowledgement Hamer acknowledges support from the National Institute for Health Research
(NIHR) Leicester Biomedical Research Centre, which is a partnership between University
Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester.

References

1. Townsend N, Wilson L, Bhatnagar P et al (2016) Cardiovascular disease in Europe: epidemio-
   logical update 2016. Eur Heart J 37(42):3232–


2. Hansson GK, Libby P (2006) The immune response in atherosclerosis: a double-edged sword.
   Nat Rev Immunol 6(7):508–


3. Luengo-Fernandez R, Leal J, Gray A et al (2006) Cost of cardiovascular diseases in the United
   Kingdom. Heart 92(10):1384–

Table 1.1 Goals and recommendations for physical activity and cardiovascular disease risk

Evidencea

Goal Evidence statement Type Strength

Minimal benefit

At least 150 minutes of

moderate-intensity aerobic

activity per week

Physical activity is inversely associated

with cardiovascular disease risk

C 1

Physical activity acts favourably on low

grade inflammation and haemostasis

B 3

Physical activity acts favourably on

lipid profiles

B 1

Physical activity reduces blood pressure B 1

Physical activity improves

cardiorespiratory fitness

B 1

Greater benefit

Performing some

vigorous-intensity aerobic

exercise on a weekly basis

Vigorous exercise confers greater

protection against cardiovascular

mortality, especially in men

C 2

Moderate- to vigorous-

intensity activity

Moderate-vigorous activity confers

‘optimal’ benefits for blood pressure

lowering, haemostasis and lipid levels

B 3

aType of evidence: (A) major randomized, controlled trials (RCTs); (B) smaller RCTs and meta-

analyses of other clinical trials; (C) observational and metabolic studies; (D) clinical experience.
Strength of evidence: (1) very strong evidence; (2) moderately strong evidence; (3) strong trend

M. Hamer et al.