Training Strategies to Optimize Cardiovascular Durability and Life Expectancy

Abstract

The optimal dose of physical activity and best types of exercise for improving cardiovascular (CV) durability and optimizing longevity are unknown. The purpose of this article is to review the recent literature on the effects of duration and intensity of exercise, physical fitness, and specific types of training/sports on long-term CV health and life expectancy. A systematic review of recent studies (2011 to 2022) was conducted using PubMed. Studies were included if they addressed the topic of fitness and/or exercise dose/type and CV health and/or life expectancy. Epidemiological studies show that cardiorespiratory fitness (is inversely related to risk of all-cause mortality, with no increased mortality risk in the most fit cohort. Being unfit is among most potent risk factors for all-cause mortality. Moderate PA (MPA) and vigorous PA (VPA) were associated with reduced CV and all-cause mortality in a recent definitive study. Paradoxically, high doses of MPA reduced both CV and all-cause mortality better than did high doses of VPA. A large meta-analysis showed that strength training was independently associated with lower rates of all-cause mortality and CV disease, though the best outcomes were associated with a cumulative dose of about 60 minutes/week. Physical interactive play is strongly associated with improved life expectancy. Physical fitness is a key determinant of CV health and life expectancy. Moderate to vigorous exercise, strength training and interactive sports are associated with improved life expectancy. Very large volumes of strenuous exercise and/or weightlifting may not be the ideal for optimizing longevity.

Figures 1a, 1b

Hazard ratios (HR) for all-cause mortality (1a) and CV disease (CVD) mortality (1b) as a function of dose of VPA and MPA. Used with permission.

Figure 2

Survival Curves According to Cardiorespiratory Fitness Categories as measured by time achieved on a Bruce protocol treadmill exercise test. Used with permission.

Figure 3

J-shaped dose–response curves for weekly dose of muscle-strengthening activities and all-cause mortality. Used with permission.

Figure 4

Kaplan-Maier survival curves based on SRT scores. Used with permission.

Figure 5

Life expectancy gains according to sports/exercises performed by individuals in the Copenhagen City Heart Study. Original author no permission needed.