How does physical activity affect the risk for coronary artery disease (CAD)?

Updated: Mar 30, 2020
  • Author: F Brian Boudi, MD, FACP; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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Answer

The cardioprotective benefits of exercise include reducing adipose tissue, which decreases obesity; lowering blood pressure, lipids, and vascular inflammation; improving endothelial dysfunction, improving insulin sensitivity, and improving endogenous fibrinolysis. [37] In addition, regular exercise reduces myocardial oxygen demand and increases exercise capacity, translating into reduced coronary risk. In the Women's Health Initiative study, walking briskly for 30 minutes, 5 times per week, was associated with a 30% reduction in vascular events during a 3.5-year follow-up period. [38] Studies have also shown that even 15 minutes a day or 90 minutes a week of moderate-intensity exercise may be beneficial. [39] Adherence to a healthy lifestyle is associated with a low risk of sudden cardiac death among women. [40]

In a prospective study that evaluated cardiorespiratory fitness (via treadmill exercise test) and cardiovascular risk in 4872 young adults (aged 18-30 years) over 1 year, with 2472 of them followed up after 7 years (median follow-up: 26.9 years), Shah et al found that higher levels of fitness at the baseline study visit and improvement in fitness early in adulthood were associated with lower risks for CVD and mortality. [41] In addition, fitness and changes in fitness correlated with myocardial hypertrophy and dysfunction but did not affect coronary artery calcification.

Evidence suggests that screen-based entertainment (television or other “screen time”) increases the risk of cardiovascular disease, regardless of physical activity. [42] The relationship between inflammatory and metabolic risk factors may partly explain this relationship.


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