If you pay attention to the latest health discoveries, you already know that an inactive lifestyle and low physical condition, two traits that characterize many people with arthritis, increase the chances that a person will develop several potentially fatal chronic diseases, including coronary artery disease, high blood pressure, diabetes, and possibly stroke and cancer. As you may also know, coronary artery disease, which causes heart attacks, is the leading cause of death in the United States and in most other industrialized countries. Although you may not necessarily die as a direct result of your arthritis, it can lead to a lifestyle that is deadly. People who use their arthritis as an excuse to get up and pamper themselves by reminding themselves of their days are likely to cut back on those days.
In 1987, Dr. Kenneth E. Powell and his colleagues at the Atlanta Centers for Disease Control examined more than 40 respected studies that began in the early 1950s. The group’s goal was to assess how and if exercise can prevent deaths for heart disease. They concluded that physical inactivity is just as strong a risk factor for premature heart disease as the traditional risk factor we hear so much about smoking, high blood pressure, and high cholesterol. Since the publication of Dr. Powell’s overview, several more key studies have been completed, strongly supporting the Powell group’s conclusions. One of these studies, our Aerobics Center Longitudinal Study, tracked more than 13,000 healthy Cooper Clinic patients, men and women, whose aerobic fitness ranged from low to moderate to high. Results from the 8-year follow-up of these 10,224 men and 3,124 women found that the death rates of the unfit skyrocketed compared to those of moderate and high fitness. Because the statistic was adjusted for age, a person’s age was neutralized as a contributing factor to their death. The evidence is strong that regular exercise can reduce the risk, by almost 50%, of dying from heart disease.
How does this apply to people with arthritis?
To date, no studies have specifically evaluated how exercise can alter, for better or for worse, a person’s risk of dying prematurely from heart disease. However, considering that many of the older participants in the studies mentioned above certainly had osteoarthritis (because it is almost universal in people over 65 years of age), a special study would not seem necessary. It seems logical to assume that people with osteoarthritis who exercise regularly will experience the same reduced risk of death from heart disease as active people without the condition. This seems more logical considering that there is no direct relationship between osteoarthritis, which is located in the musculoskeletal system, and coronary artery disease, which involves the cardiovascular system.
Rheumatoid arthritis is another matter. Coronary artery disease is the leading cause of death in patients with rheumatoid arthritis, as well as in the general population. Therefore, it seems likely that regular exercise is effective in reducing the risk of premature death in anyone with this condition. However, rheumatoid arthritis does not limit its damage to the musculoskeletal system. In advanced cases, the skin, heart, lungs, nervous system, eyes, blood and blood vessels, spleen, and lymph nodes can be adversely affected. Some of these complications, collectively referred to as systemic complications because they involve multiple organ systems throughout the body, can increase a person’s risk of dying prematurely. Therefore, the effect of regular exercise on the risk of dying from these systemic complications is still partly unknown.
Clearly, there is still a great deal of research to be done in this area. A small-scale, 9-year study of 75 rheumatoid arthritis patients, conducted by researchers at Vanderbilt University School of Medicine, sheds a little more light on the situation. During the course of the study, 20 of the 75 subjects died. The causes of their death were similar to those of the general population, but the researchers were surprised by one finding in particular: low functional capacity tripled the risk of death for rheumatoid arthritis patients during the study period. Functional ability was based on the subject’s ability to
a) get up from a chair, walk 25 feet, sit in a chair within a reasonable period of time
b) undo and redo five buttons as quickly as possible.
The researchers believe that the connection between low functional capacity and premature death “increases the possibility that aggressive therapy aimed at improving functional capacity may be appropriate in rheumatoid arthritis.” The obvious way to do this is through a regular exercise program.