The role of exercise in the primary and secondary prevention of atherosclerotic coronary artery disease.

Although exact definitions of exercise requirements for primary and secondary prevention of coronary disease cannot be stated with certainty on the basis of currently available information, we can make some general conclusions. The characteristics associated with lowered risk from coronary disease in apparently normal populations are: 8 MET-hours of activity during leisure time or job: walking briskly during leisure time (1 hour = 1 MET-hour) walking at job (same as above) jogging during leisure time (30 minutes of activity = 1 MET-hour) walking to and from work (same as walking above) performing very heavy work in occupational pursuits (few jobs today have those energy requirements) regularly climbing 5 flights or more of stairs (10 steps per flight) regularly walking 5 city blocks per day (12 blocks per mile) regularly engaging in strenuous sports (basketball, running, mountaineering, skiing, swimming, or tennis) accumulating activities that use 2000 or more kcal per week Conclusions concerning the prevention of reinfarction in patients who are recovering from a first heart attack include: Exercise is helpful in hastening the recovery process after myocardial infarction and should be started early in the recovery period. Exercise helps to reduce mortality when used in conjunction with a multifactorial program.