When asked about his personal recipe for old age, Winston Churchill used to answer: "First of all: No sports." While being a visionary figure in world politics researchers in cardiovascular exercise science today would unanimously reply to his medical hypothesis: "Sorry, you are wrong."
A large number of long-term observational studies clearly documented that increased levels of average daily physical activity were correlated to a reduced rate of coronary heart disease and reduced cardiac and all-cause mortality. Moderately active persons were 30-40% less likely to die from heart disease as compared to the inactive "couch potato." Despite this solid epidemiologic evidence, the proportion of people who do not engage in sports at all is ever increasing: About two thirds of all Americans, for example, do not participate in regular leisure-time physical activity. This lack of sports is closely related to the epidemic of other risk factors for future heart attacks: Obesity, diabetes, high blood pressure, and elevated cholesterol levels. Together, these inactivity-related diseases cost about US$76 billion per year to treat in the US.
But physical activity is not only beneficial in healthy people to prevent cardiovascular diseases. Also patients with stable coronary artery disease can extend their life-expectancy by engaging in sports: A recent meta-analysis revealed a significant 27% reduction of total mortality among training patients and a significant 31% reduction in cardiac mortality. Even when compared to sophisticate interventional procedures, exercise training is surprisingly effective in improving the patient's well-being. In a recent study which randomized patients with coronary 1- or 2-vessel disease to either the standard interventional treatment or to regular exercise training, we found a higher event-free survival in the training group and a similar improvement of cardiac symptoms. This finding confirms again that there is no cardiac gain without the pain of changing your inactive lifestyle.