A fascinating discussion occurred at a meeting of the European Society of Cardiology, which was held in Barcelona, Spain, during August. A number of experts took the position that doctors should work harder at getting their patients to exercise instead of simply ordering angioplasties for them.

Reporting on the meeting for the Associated Press, Maria Cheng quoted Dr. Rainer Hambrecht, a German researcher whose 2004 study of heart patients found that approximately 90 percent of those who regularly rode bicycles were clear of heart problems a year after beginning their cycling program. In contrast, just 70 percent of patients who had angioplasties were still free of heart problems a year later. Says Hambrecht, "It's difficult to convince people to exercise instead of having angioplasty, but it works."

Earlier research has indicated that about a third of heart disease and cases of stroke could be avoided if only people would walk briskly for two-and-a-half hours per week. That would translate into 280,000 fewer deaths per year from heart problems in the United States alone.

Currently less than 20 percent of heart patients perform the recommended regimen of 30 minutes of moderate physical activity five days per week. The European Society of Cardiology's spokesman Dr. Joep Perk says that two thirds of heart patients planning to have angioplasties would probably get more benefit from regular exercise.

In angioplasty, a small balloon is used to flatten an arterial blockage that has reduced the heart's blood supply. The artery is then propped into an open position by a mesh tube called a stent. Angioplasty has become a very routine type of surgery, and doctors say it is harder to convince patients to commit to regular exercise than to undertake the surgical procedure.

American College of Cardiology spokesman Dr. Christopher Cannon of Harvard University told the AP, "Most patients want the quick fix. It's a lot easier to get your artery fixed than it is to exercise every day."

However, although exercise takes longer to produce the desired results, its outcomes are considered superior to those of angioplasty. Dr. Cannon notes that while an angioplasty "only opens up one vessel blockage," exercise provides a wide array of benefits. These include, but are not limited to:

Dr. Hambrecht is presently conducting a new study that is expected to strengthen his previous finding that in some patients, regular physical exercise is more effective than surgery.

On another front in the battle against heart disease, the American Heart Association (AHA) is renewing its efforts to persuade Americans to moderate their salt intake. Salt consumption in the United States has climbed by 50 percent since the 1970s, and cases of hypertension and heart disease have risen accordingly.

The recommended daily allowance for salt is 5 to 6 grams (or 2,000-2,400 milligrams of sodium). But Americans, on the average, consume 9 to 12 grams of salt per day (or about 3,600-4,800 milligrams of sodium).

Processed foods account for much of the over-consumption of sodium in the United States. One way to lessen the damage is to read food labels and choose low-sodium products. AHA researchers estimate that if all Americans would cut 3 grams of salt out of their daily diets, there would be a quarter million fewer new instances of heart disease and more than 200,000 fewer deaths over a ten year period.

SFA member Richard Commins is an impressive role model for all who meet him, including his personal training clients in Sacramento, California. The super-fit 82 year old former Marine and retired school teacher takes care of all the gardening in his huge yard, regularly lifts weights, and follows a challenging exercise routine that includes push-ups, pull-ups, elliptical machine workouts, an emphasis on core muscles, and balance work on a trampoline. He even applied to be a contestant on the popular show "Survivor" not long ago!

Writing for the Los Angeles Times, Jeannine Stein recently compiled a good-sense listing of the ways in which physical exercise contributes to healthy aging:

Strength training helps offset age-related muscle loss. The American Geriatrics Society notes that maintaining stronger muscles (leg muscles, in particular) and better balance could result in fewer falls, which is a leading cause of death in elderly populations.

Regular aerobic exercise helps slow or even reverse the stiffening of arteries with age. Over time, a shift in the chemical composition of arterial walls increases their rigidity. Aerobic exercise fights this tendency and the resulting rise in blood pressure, which would otherwise place extra stress on the heart.

Physical activity, especially aerobic exercise, combats diabetes in more than one way. It leads muscles to use glucose from the blood for fuel, thereby keeping blood sugar levels in check. It depresses the production of insulin by the pancreas. And, it causes the liver to turn lactic acid, amino acids, and fats into glucose, which further powers the muscles and helps regulate blood sugar levels.

Exercise appears to decrease levels of C-reactive protein, which is a marker for inflammation. Inflammation, which often worsens with age, is undesirable because it increases the risk for heart disease and interferes with the work of the immune system.

Exercise promotes brain health. A study published in the American Journal of Neuroradiology in August found that older adults who performed at least 180 minutes of aerobic activity every week for 10 consecutive years enjoyed brain health benefits. Compared to a group of subjects who performed less than 90 minutes of exercise per week, the more active seniors had more small-diameter blood vessels with less twisting. Their vessel patterns were similar to those of younger adults.

Read on for an illuminating quotation provided by one of the experts interviewed for Stein's story.

Dr. Steven Blair is a professor in the Arnold School of Public Health at the University of South Carolina. Quoted by Jeannine Stein in her Los Angeles Times article "Staying healthy with age should be a . . . Moving Experience," Dr. Blair had this to say:

"Eat, drink and be merry and die happy -- who am I to argue if that's what you want to do? But I've never met anyone who has said they want to spend the last five years of their life frail, feeble and living in a nursing home. The very best insurance that you can take out to maintain your independence and be able to function is to be physically active."