Can Push-Ups Take the Place of Pills? Not Yet

Physical activity is potentially as effective as many drug interventions for patients with existing coronary heart disease and stroke, a recent analysis suggests. But don’t trade your medications for a new pair of cross-trainers quite yet. All the evidence is not in – and there are significant, life-saving reasons to continue to take your prescription medicine.
Researchers from the London School of Economics, Harvard Medical School and Stanford University School of Medicine studied 305 randomized, controlled trials and found no statistically detectable differences between exercise and drug interventions for prevention of heart disease without symptoms and prevention of diabetes. The researchers also concluded that for stroke patients, exercise was more effective than drug treatment.

Randomized, controlled studies needed

But cardiologist David Frid, MD, says it is highly premature to declare exercise as beneficial as medicine in treating these illnesses.
The analysis only looked at the results of other studies and did not test the hypothesis that exercise can be just as effective as drugs in a controlled, randomized clinical trial – science’s gold standard of research, Dr. Frid says.
Not many studies have directly considered the value of exercise as a treatment or prevention tool. Much more research is needed that compares standard drug therapy against just exercise in treating disease, he says.
“I think that saying exercise is better than medications without having truly direct comparisons is a stretch,” Dr. Frid says.

Medications help achieve results quickly

The researchers themselves say that more studies are needed. In the meantime, they say, exercise “should be considered as a viable alternative to, or alongside, drug therapy.’
“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 researchers say.
Dr. Frid says that many patients do try to eat better and exercise before trying medication therapy. Many times, however, they don’t succeed.
Patients often underestimate the amount of exercise necessary to get fit and they find dietary changes extremely challenging. While the patient works to change lifestyle habits, treating the illness remains a priority and delaying treatment is not always the best course, Dr. Frid says.
“To achieve some of the goals we’re trying to meet with patients’ cholesterol or blood pressure, it’s much more effective to treat a patient with a medication instead of just implementing lifestyle changes,” Dr. Frid says.
— The Beating Edge Team, Cleveland Clinic.org