However, for the general population, more vigorous activity results in additional benefits. There is also evidence that physical activity may prevent ischaemic stroke. The mechanism may be through reducing the risk of thrombus formation, or the effects of physical activity may be mediated through reducing blood pressure levels. These protective effects reducing the incidence and mortality from CHD are independent of the influence of physical activity on other cardiovascular risk factors. More sustained physical activity may also help with weight loss.
Physical activity has similar benefits for many patients with established coronary artery disease.
In those who become active, these benefits include increased fitness, improved oxygen consumption, and decreases in ischaemic responses. There is controlled-trial evidence that sustained vigorous activity can lead to some regression of atherosclerosis. Exercise may improve coronary endothelial-dependent vasodilatation responses, possibly leading to recruitment of collateral vessels in ischaemic heart disease. However, further work is needed to define the exact biological mechanisms. For patients with CHD, there is clinical evidence of increased functional capacity and improved myocardial perfusion after exercise training, and there may even be some benefits for those with uncomplicated heart failure.