Millions of U.S. adults share a similar mild-to-moderate heart disease risk, but they can improve those readings just with lifestyle changes as the first line of treatment, especially exercise, a recent scientific statement from the American Heart Association noted.
The paper offered guidance for doctors on how to “prescribe” more physical activity for those patients. That’s often not a comfort zone for physicians, who know how to prescribe medication but not necessarily lifestyle changes, said Bethany Barone Gibbs, a vascular researcher and chair of the group that wrote the report.
Patients, in turn, may feel intimidated when asked to exercise more, but the “prescription” shouldn’t be daunting.
“We really wanted to make sure that all clinicians feel empowered and take the scariness out of physical activity because it doesn't have to be going to the gym every day or running 5 miles every day,” Gibbs, an associate professor in the department of health and human development at the University of Pittsburgh, told TODAY.
“For people who do nothing, even increasing by 30 minutes a week can yield health benefits… we just wanted to help physicians know that physical activity is a great option. It treats both cholesterol and elevated blood pressure.”
About 21% of U.S. adults, or 53 million, have slightly elevated blood pressure according to guidelines released in 2017. That usually means the top number of the reading falling between 120-139 mmHg, and the lower number registering between 80-89 mmHg.
The authors estimated at least 28% of Americans, or 71 million, have cholesterol levels that are a little too high, with their LDL, or “bad cholesterol,” higher than 70 mg/dL.
Elevated cholesterol and blood pressure often happen together and they both increase the risk of heart disease.
That’s where exercise can come in. It addresses both problems and may be easier to implement for people than losing weight or changing diet — some of the other lifestyle treatments that can help — and it comes with many other health benefits.
“A lot of people don't want to start medication, so this is really a critical moment of motivation,” Gibbs said.
“A physician giving a (physical activity) prescription really motivates patients… they're going to take that more seriously.”
How much exercise is needed to have an impact?
The statement recommends the federal Physical Activity Guidelines, which call for 150–300 minutes of moderate-intensity physical activity per week, or 75–150 minutes of vigorous-intensity exercise or an equivalent combination of both.
That's the best case scenario, but every minute counts: “Actually, the steepest improvements happen from starting with nothing and getting a little bit,” Gibbs said.
Even short spurts of exercise are beneficial, researchers have found.
What kind of exercise is best?
Any kind of exercise that you want to do and that you'll keep doing, she noted. Aerobic exercise and resistance exercise can both provide the cholesterol- and blood pressure-lowering benefits.
For someone who doesn't exercise at all, brisk walking is the best recommendation, because people know how to do it, it’s easy to incorporate into a daily routine and doesn’t require any equipment, Gibbs noted.
Many people already have an activity tracker on their phone or smartwatch, so it could be just a matter of looking at how many steps they take now and boosting that number a bit. “It doesn't have to be so hard,” she said.
A recent study found light physical activity — like walking, gardening or house work — spread throughout the day is key to get the benefits of exercise.
How long will it take to have an impact?
Exercise can lower a person’s blood pressure the next day, but of course, the goal is to achieve a sustained change, which would take about three months of regular exercise, Gibbs said.
“We're just really advocating that doctors, clinicians, nurse practitioners and anyone who is in contact with patients really, really prescribes exercise because it honestly, it has so many health benefits. It can treat almost anything,” Gibbs said.