A recent study made international headlines when it found that exercise was just as effective as—or sometimes even outperformed—drugs when treating such conditions as heart disease and stroke.

The details: After examining about 300 medical trials involving more than 330,000 patients, Harvard researchers found that frequent exercise and powerful drugs, such as beta-blockers and blood thinners, provided very similar results. And in the case of stroke recovery, regular workouts were actually more effective than taking anticoagulant medications.

A troubling fact: Only one-third of clinicians “prescribe” exercise, which could not only boost the health of Americans significantly but also save the average patient thousands of dollars a year in medical costs.

My recommendations for condition-specific routines that contribute to a healthy, disease-free future…*


Drugs such as beta-blockers help treat heart disease, but side effects can include fatigue, dizziness, upset stomach and cold hands. Meanwhile, a single 40-minute session of aerobic exercise has been shown to lower blood pressure for 24 hours in hypertensive patients, and regular workouts can reduce both systolic (top number) and diastolic (bottom number) blood pressure by five to 10 points. Consistent exercise also can improve cholesterol levels.

Why exercise works: The heart is a muscle, and cardiovascular exercise forces it to pump longer and eventually makes it stronger, preventing the buildup of plaques that can rupture and lead to a heart attack or stroke. Many heart attack and stroke survivors are afraid to exercise, but it’s crucial that they move past this fear. Those who exercise require less medication…need fewer major surgeries such as bypasses…and are 25% less likely to die from a second heart attack than their couch potato counterparts.

What to do: Five times a week, do 30 to 40 minutes of cardiovascular exercise at a “Zone 2” level of exertion (see below). You have lots of choices for this exercise. Options include very fast walking, jogging, swimming, using an elliptical machine or recumbent bike, or taking an aerobics class. Pick an activity you enjoy to help you stay committed. After just six weeks, you’ll likely have lower blood pressure, and by three months, your cholesterol levels should be improved.

Note: People with heart failure, a condition in which the heart cannot pump enough blood to the rest of the body, should avoid resistance exercises, such as push-ups and heavy weight lifting, that force muscles to work against an immovable or very heavy object. Such activities can put an excessive burden on the heart and cause further injury to it.


Exercise really is nature’s anti­depressant. Several studies have shown that working out is just as effective, if not more so, than medication when it comes to treating mild-to-moderate depression. Exercise also can help reduce the amount of medication needed to treat severe cases of depression…and even prevent depression in some people.

A Norwegian study that tracked about 39,000 people for two years found that those who reported doing moderate-to-high physical activity, including daily brisk walks for more than 30 minutes, scored significantly lower on depression and anxiety tests compared with nonexercisers.

There are many effective antidepressant drugs, but they are frequently accompanied by bothersome side effects, including sexual dysfunction, nausea, fatigue and weight gain. And while most of these drugs can take a month to work, a single exercise session can trigger an immediate lift in mood, and consistent aerobic exercise will make an even more lasting positive impact.

What to do: The key is to boost your heart rate high enough to trigger the release of endorphins, feel-good chemicals that elicit a state of relaxed calm. Spend 30 to 45 minutes at a “Zone 3” level of exertion (see below), three to five days a week, to benefit.

You also may want to try exercising outdoors. A study published in Environmental Science & Technology found that outdoor exercise produces stronger feelings of revitalization, a bigger boost of energy and a greater reduction in depression and anger than exercising indoors.

Strength training also is effective in treating depression—lifting weights releases endorphins and builds a sense of empowerment. For a strength-training program, ask your doctor to recommend a physical therapist or personal trainer.

If it’s difficult to motivate yourself to exercise when you’re depressed, relying on a personal trainer—or a “workout buddy”—can help.


Back pain strikes roughly half of Americans. Pain medications are available, but many are addictive and merely mask the symptoms rather than address the underlying problem. Muscle relaxants cause drowsiness…overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can lead to ulcers…and steroid injections, which can be given only a few times per year, can cause infection or nerve damage and long-term side effects such as osteoporosis or high blood pressure.

What to do: There’s a very powerful low-tech solution—a foam roller. Widely available at sporting-goods stores, these cylindrical rollers have a record of preventing and relieving back pain. With the cylinder on the floor, move various muscles (your hamstrings, quadriceps and lower back) back and forth over the foam roller slowly. Roll each area for one to two minutes. If you hit an especially tender spot, pause and roll slowly or hover in place until you feel a release. The entire routine should take about 10 minutes.

Note: Rolling muscles can feel uncomfortable and even painful at first. But the more painful it is, the more that muscle needs to be rolled. Frequency eases discomfort.

In addition to rolling your mus­cles, start a back- and core-strengthening program. Avoid using heavy weights, especially within an hour of waking—that’s when your muscles are tighter and you’re more likely to strain a muscle.

Instead, opt for higher repetitions (three sets of 15) with lighter weights (three to five pounds for women and eight to 10 pounds for men) to build endurance in your back and core, which is more protective than sheer strength.

A good core-strengthening exercise: The plank. In a push-up position, bend your elbows and rest your weight on your forearms (your body should form a straight line from shoulders to ankles). Pull your navel into your spine, and contract your abdominal muscles for 30 seconds, building up to a minute or two at a time. Perform the plank once a day.

The 3 Exercise-Exertion Zones

There are three main levels of exertion that are based on how easy it is for you to talk…

Zone 1: Talking is easy while moving. An example of Zone 1 exertion might be a moderate-paced walk.

Zone 2: Talking is tough but manageable. In Zone 2, there should be a little huffing and puffing but no gasping for air.

Zone 3: Carrying on a conversation is quite difficult at this level of exertion due to panting.

*Be sure to check with your doctor before starting any fitness program. If your condition is severe, he/she may initially want you to use exercise as an adjunct to medication, not as a replacement. Never stop taking a prescribed drug without talking to your doctor. Caution: With any of these workouts, seek immediate medical attention if you experience chest pain, shortness of breath, nausea, blurred vision or significant bone or muscle pain while exercising.

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