Fitness, Heart Disease, and High-Density Lipoproteins: A Look at the Relationships

In brief: Coronary heart disease (CHD) causes over 500,000 deaths per year in the United States, although this rate is declining. Preventive strategies have focused on reducing modifiable risk factors such as hypertension, cigarette smoking, and serum cholesterol levels. However, physical activity can exert a preventive effect as well. High-density lipoprotein cholesterol (HDL-C), which seems to be the most critical determinant of risk of CHD, increases with greater fitness levels. On the basis of this literature review, the author recommends that future research programs include more precise measurements of fitness as well as determination of certain parameters of lipid metabolism, such as HDL-C, apolipoproteins, and lipoprotein lipase.