Lifestyle and the Risk of Cardiovascular Disease in Women: Is Physical Activity an Equal Opportunity Benefactor?

Cardiovascular disease is the number one killer of women in the United States. It is estimated that 36.6% of women older than age 20 have some form of cardiovascular disease. In 2004, an estimated 459 100 women died from cardiovascular disease, more than 10 times the number of women who died from breast cancer that same year. Regular physical activity of moderate intensity, such as brisk walking, reduces the risk of cardiovascular disease and mortality in women. The benefits of more vigorous exercise are not clear, but the apparent lack of a dose-response relationship between exercise intensity and cardiovascular benefit may be the result of the design of many epidemiologic and interventional studies. Studies examining the benefits of greater cardiorespiratory fitness for women are limited, but the data suggest that they are similar to that of men. Women may require greater caloric expenditure than men for weight reduction, but this issue may be confounded by other variables such as caloric intake and spontaneous physical activity. The risk of cardiovascular disease associated with type 2 diabetes is much greater in women than in men. Regular physical activity and greater cardiorespiratory fitness are associated with a lower incidence and prevalence of type 2 diabetes in women. Greater cardiorespiratory fitness has also been found to be protective of the metabolic syndrome, but the benefit of physical activity is unclear. Limited evidence suggests that moderate-intensity activities can lower systolic blood pressure in women. There is a pressing need for more research into the health benefits of regular physical activity in women.