Heart Health

Updated 03 October 2013

Exercise as good as medication for heart disease

Exercise may be just as good as medication to treat heart disease and should be included as a comparison when new drugs are being developed and tested.

Exercise may be just as good as medication to treat heart disease and should be included as a comparison when new drugs are being developed and tested, scientists say.

In a large review published in the British Medical Journal, researchers from Britain's London School of Economics and Harvard and Stanford universities in the United States found no statistically detectable differences between exercise and drugs for patients with coronary heart disease or pre-diabetes, when a person shows symptoms that may develop into full-blown diabetes.

For patients recovering from stroke, the review – which analysed the results of 305 studies covering almost 340 000 participants found that exercise was more effective than drug treatment. Cardiovascular disease is the world's number one killer, leading to at least 17 million deaths a year. "Exercise seems to be as potent of an agent as drugs can be in these common chronic conditions," Huseyin Naci, the study's lead author and a fellow at Harvard Medical School in Boston, said.

The review also said the amount of trial evidence on the health benefits of exercise is considerably smaller than that on drugs, which the scientists said may have had an impact on their results. "First and foremost, we need a lot more research on exercise," Naci told Reuters Health. "We have a huge blind spot in the current medical research... We simply don't know many of the conditions where exercise can be as effective as or even more effective than drugs. "The review adds to a large body of evidence showing that regular exercise is key to human health.

Leading risk factor

According to the Geneva-based World Health Organization (WHO), physical inactivity is the fourth leading risk factor for global mortality, causing an estimated 3.2 million deaths around the world each year.

The WHO says regular moderate intensity physical activity such as walking, cycling or participating in sports can reduce the risk of cardiovascular diseases, diabetes, colon and breast cancer, and depression, as well as cutting the risk of bone fractures and helping to control body weight.

In the United States, where health experts estimate half of adults will be obese by 2030 unless lifestyle habits change, the Centres for Disease Control and Prevention says less than 48% of adults exercise enough to improve their health.

One limitation of the review, Naci said, is that most of the individual studies the researchers analysed did not compare exercise and drugs directly.

He warned that the findings do not mean everyone with a heart condition should abandon their drugs in favour of exercise. "Patients should not even consider stopping their medications without talking to their doctor," he said. "There is really a need for conversations between patients and doctors to see if exercise can be an option for them."


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