American College of Cardiology

American College of Cardiology

March 18, 2019
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Physical activity ‘prescription’ key for cardiologists

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Carl Lavie Jr
Carl Lavie Jr

NEW ORLEANS — Despite physical activity guidelines, most cardiologists do not feel they are educated enough to prescribe physical activity to their patients, but should do so, according to an expert who spoke at the Vascular Biology Working Group.

Carl Lavie Jr., MD, professor of medicine at Ochsner Medical Center, New Orleans, made the case that there is adequate literature that demonstrates that “fitness improves longevity” and is crucial to CV health.

“Many clinicians ... are not giving adequate assessment or intervention information on physical activity,” Lavie said noting it is not just clinicians but also advanced practice nurses, dieticians, pharmacists and physical therapists.

As Cardiology Today previously reported, the American Heart Association and HHS released the second edition of the Physical Activity Guidelines for Americans in November 2018.

With these practical guidelines “the biggest bang for the buck was going from no activity to even small amounts of activity,” he said. “Drs. Giroir and Wright from the [HHS] made the point of how much implementing these guidelines could affect the health of Americans not to mention cost.”

The authors estimated that $120 billion in cost per year could be avoided, Lavie said.

The Physical Activity Guidelines for Americans recommend 150 to 300 minutes of moderate physical activity per week or 75 minutes per week of vigorous physical activity for all Americans, he said.

The guideline gamechangers for Lavie were that the activity could be concentrated in 1 or 2 days and produce the same effect and that “all movement counts.”

Despite physical activity guidelines, most cardiologists do not feel they are educated enough to prescribe physical activity to their patients, but should do so, according to an expert who spoke at the Vascular Biology Working Group
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Lavie also said that the guidelines indicate that adults should participant in two or more sessions of resistance or weight training, both of which activities are associated with mortality benefits. Older adults — over 80 years — should also incorporate balance training.

Lavie discussed other important guideline changes that cardiologists should implement.

Children aged 3 and 5 years should be active throughout the day and children aged 6 to 17 years should participant in at least 60 minutes per day of moderate to vigorous physical activity.

“Implementing these [guidelines] will certainly have tremendous benefits on health care system and society,” he said.

But the main issue is “that when you question physicians ... even I don’t think it is rocket science ... [they generally] say they don’t feel trained to adequately assess or adequately give advice.”

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“We need to make changes throughout our system to accomplish this,” he said, because current levels of physical activity are well below the guidelines. “Any movement is better than no movement.” – by Joan-Marie Stiglich, ELS

References:

Lavie C. New physical activity guidelines: Movement anytime, anywhere? Presented at: Vascular Biology Working Group; March 15, 2019; New Orleans.

Giroir BP, et al. JAMA. 2018;doi:10.1001/jama.2018.16998.

Piercy KL, et al. JAMA. 2018;doi:10.1001/jama.2018.14854.

Thompson PD, et al. JAMA. 2018;doi:.10.1001/jama.2018.16070.

Disclosure: Lavie reports no relevant financial disclosures.