Exercise as therapy

Risposta: Aerobic exercise is not merely a recreational pastime, but constitutes a genuine non-pharmacological medical therapy, with precise dosages and no side effects when carried out correctly. Regular physical activity has a positive effect on almost all cardiovascular risk factors. At the vascular level, aerobic exercise stimulates the endothelium to produce nitric oxide (NO), a powerful natural vasodilator that reduces peripheral resistance, thereby stabilising and lowering both systolic and diastolic blood pressure. Metabolically, exercise increases tissue sensitivity to insulin, improving blood glucose control and raising levels of HDL (‘good’) cholesterol, whilst helping to reduce triglycerides and visceral fat.

International guidelines recommend at least 150–300 minutes per week of moderate-intensity aerobic activity (such as brisk walking, cycling or swimming) or 75–150 minutes of vigorous activity, spread over 4–5 sessions per week. Even just 30 minutes a day, 5 days a week, is enough to bring about a significant reduction in the risk of cardiovascular mortality.

Physical activity has a direct effect on the autonomic nervous system, reducing sympathetic tone and increasing vagal tone, a condition that protects the heart from the onset of life-threatening arrhythmias. Recent scientific evidence, including a major recent Norwegian study, has shown that regular exercise significantly reduces the incidence and symptom burden of atrial fibrillation in people with this arrhythmia.

Furthermore, for those who have already suffered a medical condition — such as a myocardial infarction, heart failure or revascularisation or valve replacement surgery — physical activity prescribed as part of a tailored cardiac rehabilitation programme drastically reduces the risk of recurrence and overall mortality. The advent of telemedicine and wearable devices (smartwatches and monitoring sensors) now makes it possible to monitor patients remotely whilst they exercise, adjusting the intensity of the workout based on real-time heart rate and oxygen saturation, thereby ensuring maximum safety and personalised care.

It should be noted that Italia is a world leader in the manufacture of exercise equipment and that this equipment is now capable of remotely monitoring both the vital signs of the person exercising and the type of activity being performed. In short, this opens up great opportunities for practising a form of sport that is truly tailor-made and completely safe.