Fitness Levels and Heart Health

The fact that regular exercise promotes healthfulness is well established. However, today's society, with the conveniences, technologies, and lifestyles it promotes, continues to reduce our need and our free time to be physically active.⁹⁸ Physical inactivity substantially increases the risk of heart disease, type 2 diabetes, hypertension, and obesity.⁹⁹

Asymptomatic women with low exercise capacity are at increased risk for all-cause mortality—those unable to perform at least 5 METs are at 3 times the mortality risk of those able to perform more than 8 METs.⁶⁷ Given such risks, physical activity should be given a high priority, and physician encouragement is particularly important.⁹⁸

Click on the links below for more information:

• Fitness and Cardiovascular/Metabolic Risk
• Fitness Is Important for Women
• Even Small Increases in Activity May Reduce Risk

Fitness and Cardiovascular/Metabolic Risk

• Low cardiorespiratory fitness is a strong and independent predictor of metabolic syndrome in both men and women.¹⁰⁰
• Metabolic syndrome risk is inversely proportional to increasing levels of fitness (P = .01 for women).¹⁰⁰
• There is a large difference in cardiovascular risk between people who are least active or least fit and those who are only modestly more active or fit.¹⁰¹
• Even energy expenditure from everyday physical activities is independently predictive of progression toward metabolic syndrome in a dose-dependent manner.¹⁰²
• Low levels of activity-related energy expenditure in our society may be the major behavioral causal factor in the increasing prevalence of diabetes.¹⁰³
• In a study of 4884 normotensive women, cardiorespiratory fitness had a strong inverse relationship with the risk of developing hypertension.¹⁰⁴
• In both normal weight and overweight women, those with moderate or high cardiorespiratory fitness had 41% to 61% lower relative odds of hypertension than their low-fitness counterparts.¹⁰⁴

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Fitness Is Important for Women

Fitness may be more important than overweight/obesity for cardiovascular risk in women.¹⁰⁵ In the WISE* study¹⁰⁵:

• Self-reported physical fitness scores were independently associated with angiographic CAD and adverse cardiovascular events.
• Higher fitness levels were independently associated with:
• Fewer CAD risk factors
• Less angiographic CAD
• Lower risk for cardiovascular events
• Women in the low-fitness group had the highest risk of adverse cardiovascular events, regardless of BMI.

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Even Small Increases in Activity May Reduce Risk

• Increased physical activity and fitness should be used for the primary prevention of hypertension¹⁰⁴ and should be an important part of strategies for addressing diabetes and its complications.¹⁰³
• Relatively small changes in activity or fitness in sedentary persons may produce large reductions in disease risk at the population level.¹⁰¹
• Everyday physical activities that elevate energy expenditure are important in the primary prevention of metabolic syndrome, regardless of aerobic fitness level.¹⁰²
• Small changes in physical activity may be more feasible than promoting large changes.¹⁰²

_{*Women's Ischemia Syndrome Evaluation.}

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