Could exercise be as good as some drugs for certain health conditions?

Kathleen Blanchard's picture
Maybe exercise is better than some drugs, but where are the studies?
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We've all become accustomed to getting a prescription when we go to the doctor, right? But a newer study has found when it comes to treating certain diseases, it's possible that exercise is better than some drugs. So, why aren't there more studies?

The finding, published in the British Medical Journal (BMJ) this month found exercise was better than several drugs for secondary prevention of coronary artery disease, drugs did little for treating prediabetes and exercise was better than typical drugs given to patients for stroke rehabilitation.

In their study review, researchers say they found no difference in death rates between exercise and taking drugs for the secondary prevention in coronary heart disease and prediabetes that is the result of insulin resistance and can lead to full blown type 2 diabetes.

Patients who have suffered a stroke fared better when they exercised compared to those who take anticoagulants live clopidrogel, aspirin and other anticoagulants and antiplatelet drugs.

We know that exercise can relax the blood vessels and improve blood flow, helping to prevent clots and keep blood pressure lower. Exercise also reduces inflammation that is a key contributor to heart disease.

Huseyin Naci, MHS, from the London School of Economics and Political Science in the United Kingdom and the Drug Policy Research Group, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, and John P.A. Ioannidis, MD, from the Stanford Prevention Research Center, Stanford University School of Medicine in California collaborated on the study.

The researchers looked at 16 study analyses to come to their conclusion; four of which looked at exercise and 12 that measured the effect of drugs.

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The studies explored by the researchers were limited simply because few studies compare exercise benefits to taking drugs.

"Even in treatment areas where such evidence exists, exercise trials evaluating mortality outcomes were at a disadvantage in two ways: considerably fewer trials evaluated exercise than drugs...and fewer people participated in exercise trials," the authors wrote.

For instance, there is plenty of 'evidence' that cholesterol lowering drugs can prevent deaths from coronary artery disease, but the benefit of exercise for secondary prevention is lacking in clinical trials.

The analysis showed statin drugs do lower death rates by preventing coronary heart disease for those at risk, but exercise produced similar results.

When it came to stroke, exercise appeared to be more beneficial than any drug intervention, but the study authors say they're a bit uncertain because there were - again - so few events in exercise trials.

For prediabetes, neither drug nor exercise seemed to be associated with lower mortality; for heart failure, fluid pills known as diuretics were associated with fewer deaths.

"Given the scarcity of financial resources to fund future trials of exercise interventions, one option would be to require such evidence from pharmaceutical companies," the authors write. "In cases where drug options provide only modest benefit, patients deserve to understand the relative impact that physical activity might have on their condition."

The finding suggests exercise just might be as good as drugs for lowering deaths related to some diseases.

Source:
BMJ
October 2, 2013

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