Can exercise be as effective as medication to treat people with heart disease, Type 2 diabetes, and stroke?
Researchers seem to think so.
In a study published in the British Journal of Medicine this past week, physical activity (including regular exercise) was deemed to be potentially as effective as many drug treatments.
Researchers form the London School of Economics, Harvard Medical School and Stanford University’s School of Medicine compared the effectiveness of exercise versus drug treatments on mortality rates across four health conditions by analyzing the results of over 300 randomized control trials involving over 300,000 individuals. For two of those conditions (secondary prevention* of coronary heart disease and prevention of diabetes), the researchers found no statistically detectable differences between exercise and medication.
*Secondary prevention refers to the treatment of patients who already have a disease but who have not yet developed any significant illness.
To set this in context, cardiovascular disease claims at least 17 million lives a year worldwide, making it the number one cause of premature death. In those cases where drug interventions provide only modest benefits, especially when compared to exercise, patients should be made aware of the relative impact of exercise vs. drug therapy, the researchers argue.
What about the other two conditions they examined? For stroke, the good news is that exercise was considered to be more effective than drug interventions. For heart failure, however, drug therapies (specifically the use of diuretics) were more effective than exercise.
The authors of the study did note, however, that there are many more trials into the effectiveness of drug therapies than there are for exercise studies, so this may have had an impact on the results. They argue that more trials comparing the effectiveness of exercise and drugs are urgently needed to help doctors and patients make the best treatment decisions. In the meantime, they say exercise “should be considered as a viable alternative to, or alongside, drug therapy”. And they call on regulators to consider requiring pharmaceutical sponsors of new drugs to include exercise in their trials as part of the control group.
What was not specified in the research was the type of exercise needed but based on previous studies, cardiovascular (or aerobic) exercise is considered to be the most beneficial for these types of conditions. This is reflected in Canada’s Physical Activity Guidelines, which state that at least 150 minutes of moderate-to-vigorous physical activity, in bouts of 10 minutes or more, are required per week to achieve health benefits with at least two sessions of muscle and bone strengthening exercises in addition.
In the UK, where the study was published, only 14% of adults exercise regularly and yet prescription drug use rates have ballooned in the last 10 years from an average of 11.2 prescriptions per person in 2000 to 17.7 prescriptions in 2010. Numbers are not much better in Canada, where only 15% of Canadians meeting the physical activity guidelines. As for prescription drug use in Canada, drug expenditures are growing faster than any other component of health care. If you include non-prescription drugs as well, Canadians spent over 30 billion dollars in 2010 or an average of $836 per person, second highest in the world, after the US, which spends $1,062 per capita.
Always discuss treatment options with your doctor. And be sure to let you doctor know if you exercise regulary. Your doctor needs to know this in order to prescribe what is best for you and you need to know all of your treatment options.