Exercise and heart disease in women: why, how, and how much?

Despite a traditional view that cardiovascular disease primarily affects men, a growing body of information now recognizes that it is a disease that equally affects women and is the leading cause of morbidity and mortality in women in the United States. Both physical activity and physical fitness have been shown to have an inverse association with coronary heart disease and cardiovascular risk factors. Furthermore, physical inactivity is now recognized by the American Heart Association as an independent risk factor for coronary heart disease. However, national surveillance programs have reported that 1/4 of adults are currently sedentary, and 1/3 of women do not engage in any leisure-time physical activity. Regular exercise may significantly impact coronary heart disease in women, as some coronary risk factors have a stronger predictive value for coronary heart disease in women as compared with men. Recent studies have shown that women who exercise regularly are less likely to develop diabetes mellitus; exercise may reduce blood pressure and produce improvements in lipid profiles. Conflicting data exist regarding the dose and intensity of exercise necessary to achieve significant health benefits; however, many reports demonstrate a reduced risk of mortality from cardiovascular diseases and from all causes with only moderate intensity physical activity. The Centers for Disease Control, American Heart Association, and American College of Sports Medicine recommend a regular pattern of physical activity of moderate intensity, which can be accumulated throughout the day and should be performed at least 3 to 5 days per week. In addition, the benefit of weight-bearing exercise should be underscored in women, because it plays an important role in the prevention and treatment of osteoporosis. Continued efforts are necessary to encourage the many American women who are currently inactive to make even modest increases in levels of physical activity to achieve substantial cardiovascular, as well as other, health benefits.