Cardiovascular Disease and Exercise

One of the important beliefs of the American College of Sports Medicine (ASCM), is that exercise is medicine and exercise can prevent and treat diseases. Cardiovascular diseases, such as coronary heart disease, hypertension, and strokes, account for about one-third of deaths in the United States (Kenney, Wilmore, & Costill, 2015). Cardiovascular diseases are highly preventable with physical activity and lifestyle modifications. The ASCM recommends that to help offset cardiovascular disease, a person should obtain a 150 minutes of moderate intensity aerobic exercise per week in five thirty minute sessions, or 75 minutes of vigorous aerobic exercise per week in three sessions lasting greater than twenty minutes, which equals 500-1000 MET minutes per week (Garber et al., 2011). Other organizations and disciplines have similar guidelines.

The American Society for Exercise Physiologists (ASEP) also believes in exercise being medicine. While ASEP has no firm guidelines on time or intensity for preventing cardiovascular disease, Boone (2016) explains that a person with a higher exercise capacity, needs a higher dose of activity than a sedentary person to achieve a similar health benefit. The American Heart Association (AHA) performed a meta-analysis on studies related to biomarkers related to cardiovascular diseases and exercise. The researchers concluded that aerobic exercisers had better lipid profiles, lower triglyceride levels, lower levels of fasting insulin, lower LDL levels, and higher HDL levels (Linn et al., 2015). The AHA also found that both vigorous and moderate levels of activity produce similar benefits in regards to metabolic markers (Linn et al., 2015). Lastly the journal, Current Diabetes Reports, details that strength training 2-3 times per week decreases factors for cardiovascular disease such as decreasing resting blood pressure, and decreasing visceral abdominal fat (Gaesser, 2007).

Research shows that exercise decreases cardiovascular disease risk. By synthesizing the data from different organizations, an exercise professional can combine the guidelines to better help their clients understand cardiovascular disease prevention. First I would use Rating of Perceived Exertion (RPE) in measuring intensity. Most people do not understand METs and do not have access to VO2 testing. Also, since fitness is relative a workload of 5 METs could be either easy for one person or extremely difficult for another. The 6-20 RPE scale matches closely with heart rate, VO2, and lactate threshold when measuring exercise intensity (Palmer, 2016). Working at an RPE of 9-12 would equal moderate intensity, while an RPE of 13-16 would equal a vigorous intensity (Palmer, 2016).

Since moderate intensity and vigorous intensity have similar health benefits, it would be dependent on an individual’s time constraints and exercise tolerance on which intensity to choose. For beginners and less fit individuals, moderate intensity would most likely be best as they are unlikely to be able to tolerate, much less repeat an intense workout. As cardiovascular conditioning improves, intensity can be gradually increased. A full body resistance training program should also be performed at least twice a week to further decrease a person’s risk of cardiovascular disease.

References

Boone, T. (2016). Exercise medicine and a vascular perspective. Journal of Professional Exercise Physiology, 14(1), 1-3.

Gaesser, G. A. (2007). Exercise for prevention and treatment of cardiovascular disease, type 2 diabetes, and metabolic syndrome. Current Diabetes Reports, 7(1), 14-19.

Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I., . . .

Swain, D. P. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults. Medicine & Science in Sports & Exercise, 43(7), 1334-1359.

Kenney, W. L., Wilmore, J. H., & Costill, D. L. (2015). Physiology of Sport and Exercise (6th ed.). Champaign, IL: Human Kinetics.

Linn, X., Zhang, X., Guo, J., Roberts, C. K., Mckenzie, S., Wu, W., . . . Song, Y. (2015). Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Journal Of The American Heart Association, 4(7), 1-29.

Palmer, E. (2016). Borg rating of perceived exertion scale. CINAHL Rehabilitation Guide, 6-10.