Cardiovascular Fitness and Cholesterol

A lot of attention gets paid to the role of cholesterol, particularly low-density lipoprotein (LDL) cholesterol, in causing cardiovascular disease, and rightly so. Decades of research have offered plenty of evidence that as LDL cholesterol levels increase, so does the risk for cardiovascular disease—especially coronary artery disease.

Thankfully, much can be done to keep LDL cholesterol levels in check, including diet and lifestyle changes. Regular exercise that promotes cardiovascular fitness not only helps to lower LDL cholesterol levels, but also favorably impacts other components of the lipid profile. Specifically, aerobic exercise on a regular basis raises levels of high-density lipoprotein (HDL) cholesterol, which has been associated with protection against heart attacks. Regular exercise also lowers triglyceride levels, which are part of the lipid profile that may be thought of as fats in the blood.

Given that a coronary artery plaque (the key element in atherosclerosis) is built around a lipid core consisting of the “bad” cholesterol particles such as LDL, triglycerides, and other similar particles, it is highly desirable to lower these bad cholesterol levels as much as possible to help maintain healthy arteries. In addition to all the other ways in which exercise and physical activity in general can help to maintain the health of our blood vessels, lowering bad cholesterol is one that is quite helpful and easily measurable.

National guidelines recommend a minimum of 30 minutes of at least moderate physical activity at least five times per week. Getting 30 minutes every single day of the week, however, has been associated in large epidemiological studies with even greater health benefits. And other studies have shown that higher levels of cardiovascular fitness through 45 minutes or more of aerobic exercise (though not hard-core endurance exercise, which may damage the heart in individuals over the age of 40) are associated with greater longevity and a lower likelihood of developing cardiovascular disease.

Examples of what is considered to be moderate physical activity include general gardening, brisk walking, raking leaves, general housekeeping, playing doubles tennis, ballroom dancing, and bicycling at a moderate pace. Examples of vigorous physical activity include running, playing singles tennis, walking briskly uphill, fast cycling, fast swimming, and traditional aerobics. Working out in 10-minute increments counts, as long as your daily total adds up to at least 30 minutes.

As you can see from the above, working exercise into your daily routine does not have to be difficult, and the payoffs are great—including lowering that bad cholesterol!

Yasmine S. Ali, MD, MSCI, FACC, FACP, is President of Nashville Preventive Cardiology, PLLC, in Nashville, TN.  She is board-certified in internal medicine and cardiovascular disease, as well as in clinical lipidology and nuclear cardiology.  She is a Fellow of the American College of Cardiology and of the American College of Physicians.  She graduated from Vanderbilt University School of Medicine in 2001, and has made it her career’s work to follow her passion for preventing cardiovascular disease and improving heart health for as many people as possible.  In addition, Dr. Ali is also the Physician Expert for the Obesity site for www.obesity.about.com.  Each month she will be contributing an educational piece on preventing cardiovascular disease.  To learn more about Dr. Ali, visit www.preventivecardio.com.