Physical Activity and Cardiovascular Disease Prevention in the European Union

Raising physical activity levels amongst the general population has been described as ‘today’s best buy in public health.’ A more active lifestyle, even one with low intensity or short-burst types of activity, lowers CVD risks. EHN recommends, among other things, developing an EU policy that enhances physical activity, linked to policies in other relevant areas.

Executive Summary of the report “Physical Activity and Cardiovascular Disease Prevention in the European Union”

Double the risk: Physical inactivity is now established as a major risk factor for coronary heart disease and cerebrovascular disease. Inactive populations have around twice the risk of CVD compared with active populations (Relative Risk ~2). This is of the same order as the risk of smoking, high blood pressure and raised blood-cholesterol levels.

A best buy: Raising physical activity levels amongst the general population has been described as ‘today’s best buy in public health.’ This is because physical activity has such a strong effect on CVD risk and because activity levels in the European population are so low. Inadequate physical activity is more common at the community level than any of the classic risk factors for CVD – smoking, hypertension, raised blood cholesterol and overweight. The proportion of CVD incidences that could theoretically be prevented if the European population were more physically active – the Population Attributable Risk (PAR) – is estimated to be around 30-40%.

Changing lifestyle: Taking up a more physically active lifestyle, even in middle or older age, is associated with lower rates of death from coronary heart disease (CHD) and all causes. The decrease in risk is of the same order as cessation of smoking.

Low activity is better than none, but more is always better: The relationship of physical activity to health is continuous – the more a person does, the lower their risk, whatever the existing level of activity. Most studies have found the greatest difference in CVD rates between the completely sedentary and those being moderately active. There is a new consensus that even low intensity physical activity may reduce risk of CVD without having any notable influence on fitness. The public health message is that any physical activity exceeding a completely sedentary lifestyle will produce health benefits.

Accumulated activity: Another new conclusion is that short bursts of physical activity accumulated throughout the day can also be health enhancing. Short-duration activities, such as climbing stairs or walking up a hilly street, can be included in health promotion programmes.

Recommendations for the European Union

• Pan-European initiatives: Support pan-European initiatives designed to facilitate the uptake of and regular participation in physical activity and to raise awareness of the health benefits of physical activity.
• EU policies: Develop an EU policy on health that enhances physical activity and develop a broad strategy for implementation in a range of sectors. This should be linked to other policies that affect opportunities for physical activity, such as economy and finance, employment, transport, environment, regional policies, education and tourism.
• EU surveys: Monitor EU citizens’ participation in physical activity through regular surveys.
• Research into special groups: Conduct pan-European research on physical activity patterns and identification of effective promotion among children, women, the elderly and lower socio-economic groups.
• Information exchange: Encourage information exchange on the effectiveness of physical activity intervention programmes among relevant pan-European networks in areas such as health, education and training, environment, and transport.