Researchers Compare Exercise, Drugs as Cardiovascular Treatments

According to a new study conducted at Harvard Medical School, structured exercise programs may be as effective, or even more useful, than medication to treat cardiovascular conditions.

Huseyin Naci, a visiting fellow at the Medical School, and John Ioannidis, adjunct professor of Epidemiology at the Harvard School of Public Health, evaluated and synthesized the results of 305 previous studies to compare the benefits of drug and exercise regimens on disease outcomes.

After identifying four conditions for which exercise has been studied as a preventive technique—coronary heart disease, stroke, heart failure, and type-2 diabetes—Naci and Ioannidis compared the efficacy of drugs used to treat these conditions to previously-reported effects of exercise.

They found that structured physical activity was more effective than drug use in the treatment and prevention of strokes, and equally effective in the secondary prevention of coronary heart disease and diabetes.  Diuretic drugs were more successful than exercise, however, in treating heart failure.

The study is the first of its kind to use statistical techniques of network meta-analysis to compare these different health interventions.

“There is a lot of literature on the medical benefits of exercise alone,” said Naci. “There’s also quite a lot of literature on the life saving benefits of some drugs, but there really isn’t much comparing them directly, so that’s the rationale for doing this study.”

While exercise may facilitate treatment of some ailments, Naci emphasized that patients should always consult with their doctors before choosing to forgo medication. The findings “do not imply that people should stop taking their medications, because it’s just one study,” he said.

But the researchers hope their initial study will inspire continued work, especially in collaboration with pharmaceutical companies developing many of the drugs of interest.

“[Our study] will trigger debate, which is really important,” said Naci. “In cases where we have evidence of exercise, exercise seems to do really well in comparison to drugs, but there are still a lot of instances where we don’t know how exercise fares against drugs.”

The study was published in the British Medical Journal earlier this month.