The lead author advises doctors and patients NOT to

By NICHOLAS BAKALAR

OCTOBER 9, 2013

A structured exercise program may be as good or better than frequently prescribed drugs for some common cardiovascular ailments, a large meta-analysis has found. Researchers evaluated 57 randomized trials testing the effect on mortality of exercise and drugs in four prevention regimens: the secondary prevention of coronary heart disease, rehabilitation from stroke, treatment of heart failure, and prevention of Type 2 diabetes. The review, published online in BMJ, involved more than 14,000 patients.

The studies used a variety of drugs — for example, statins for the prevention of coronary heart disease, blood thinners for stroke, diuretics for heart failure, and biguanides like Glucophage and Metaglip for impending diabetes.

They found no difference in mortality between exercise and drug interventions in the secondary prevention of coronary heart disease or Type 2 diabetes. For stroke prevention, exercise programs were more effective than anticoagulants or antiplatelet medicines. And for treating heart failure, diuretic drugs were more effective than exercise. The lead author, Huseyin Naci, a fellow at Harvard Medical School, said that in most of the trials, patients were doing structured exercise programs in combination with drugs. “These findings do not imply that patients should go off their medications and start exercising instead,” he said. “We weren’t able to find many exercise trials, which adds to the limitations of the findings. But what we don’t know about exercise may be harming us.”

http://well.blogs.nytimes.com/2013/10/09/exercise-as-preventive-medicine/?_php=true&_type=blogs&_r=0 Accessed on April 11, 2014