The Study of how Zumba can reduce the risk of developing cardiovascular

disease due to atherosclerosis

Valerie Tong Jia Wei, Shanmugam Sangeetha, Lee Yan Lin,
Lim Yee Xuan, Aw Min Yi Natalie
Hwa Chong Institution
1. Introduction
According to the World Health Organisation, cardiovascular diseases are the number
1 cause of death globally.1 Moreover, in Singapore, cardiovascular diseases are the
second most common cause of deaths. 215 people die from cardiovascular diseases
everyday, amounting to 29.5% of all deaths in 2013.3
The root cause of this deadly disease is atherosclerosis 4, which is a progressive
condition that causes ones arteries to narrow and walls to lose elasticity due to the
accumulation of deposits (plague) on the inner lining. When blood flow is restricted
due to the plaque made up of fat, cholesterol, calcium and other substances,
complications arise.5
Atherosclerosis develops gradually over years and often begins from childhood.
However, no symptoms are shown until blood flow to part of the body becomes
slowed or blocked. Some of its symptoms include a weak or absent pulse, chest
pains, shortness of breaths and dizziness.6

1 Cardiovascular diseases (CVDs). (n.d.). Retrieved June 30, 2015, from

http://www.who.int/mediacentre/factsheets/fs317/en/
2Principal Causes of Death Ministry of Health." Accessed June 24, 2015.
https://www.moh.gov.sg/content/moh_web/home/statistics/Health_Facts_Singapore/Principal_Causes
_of_Death.html.
3 Singapore - Statistics - About The Heart & Heart Disease - Singapore Heart Foundation. (n.d.).
Retrieved June 21, 2015, from http://www.myheart.org.sg/article/about-the-heart-and-heartdisease/statistics/singapore/75
4 Brownstein, B. (2015, January 14). Heart Disease: Types, Prevention & Treatments. Retrieved
June 18, 2015, from http://www.livescience.com/34733-heart-disease-high-cholesterol-heartsurgery.html

5 What Is Atherosclerosis? (2014, August 4). Retrieved June 12, 2015, from
http://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis
6 Heart Attack Health Promotion Board Singapore - Healthy Living and Disease Prevention
Information. Accessed June 15, 2015. http://www.hpb.gov.sg/HOPPortal/dandc-article/530.

Significance / Objective
When the heart is infarcted, no therapy can restore it to full function. If the initial
presentation is sudden death, therapy after onset is frequently futile. A preventive
approach involving detection and correction of predisposing conditions before the
advent of overt clinical disease is required for substantial impact. (Atherosclerosis
and Coronary Heart disease Chapter 2 page 21)
Zumba, a form of exercise that incorporates dance moves involves coordination and
movement of the entire body, involves many muscles in the body. According to
present research done on atherosclerosis, physical exercise is able to reduce the
risk factors of atherosclerosis including elevated blood pressure, elevated triglyceride
concentrations, low high-density lipoprotein cholesterol (HDL-C) concentrations, and
obesity. 7
We are researching on the lack of exercise as a risk factor for getting
atherosclerosis. Thereafter, we hope to propose a form of exercise and investigate
the relationship on how it can help to reduce the chances of getting atherosclerosis.
2. Methodology
We intend to conduct a survey to estimate the prevalence of the lack of exercise in
the public. The results shown will determine if it is a significant risk factor for the
public.

trial design: (peoples attitude models to design questionnaire for survey on peoples
understanding of risk factors for atherosclerosis)
-research possible models to use in for designing the questionaire
-TA
Secondly, after determining the significance of the lack of exercise as a major risk
factor of developing atherosclerosis, we intend to research on how Zumba can
7 Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular
Disease. (2003, June 24). Retrieved June 14, 2015, from
http://circ.ahajournals.org/content/107/24/3109.full.pdf

effectively help to reduce the chances of getting atherosclerosis. This is done

through secondary research and interview with a cardiologist, Dr Lim.

How often do you exercise?

47.6%23.8%28.6%
Once or twice a week
More than 3 times a week
None at all

6
5
10
Once or twice a week

28.6%

More than 3 times a week

23.8%

None at all

10

47.6%

What do you know about Zumba?

It is a form of exercise (dance) 35%

It can reduce atherosclerosis

I have not heard of

55%
10%

3. Findings
-primary: Significance of lack of exercise as a problem --- evaluate why based on
free response question
-secondary: findings about how the modification of risk factors and the results from
the interview and secondary research
According to our survey results, % of people understand that exercise is likely to
have a positive effect on reducing risk of atherosclerosis, but
Relationship between exercise and atherosclerosis

Physical activity is defined as any bodily movement produced by skeletal muscles

that results in energy expenditure beyond resting expenditure. Exercise is a subset
of physical activity that is planned, structured, repetitive, and purposeful in the sense
that improvement or maintenance of physical fitness is the objective. 8
Numerous studies consistently have shown that higher levels of physical activity are
associated with decreased risks of coronary heart disease. 9
Physical activity both prevents and helps treat many established atherosclerotic risk
factors10. These include: elevated blood pressure, insulin resistance and glucose
intolerance, elevated triglyceride concentrations, low high-density lipoprotein
cholesterol (HDL-C) concentrations, and obesity.Regular exercise also decreases
risk of blood clots by enhancing fibrinolysis (preventing or dissolving unwanted clots)
and improves endothelial function- how the lining of the blood vessels work to keep
the arteries healthy and functioning properly.
Research11 has also shown that regular exercise slowed the progression of
Atherosclerosis by reducing plague formation in arteries by 30%, stabilised
atherosclerotic plague by decreasing inflammation in arteries, and increased smooth
muscle cells (by 58%) by making the plague less likely to rupture.

8 Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular
Disease." Circulation. Accessed June 24, 2015.
http://circ.ahajournals.org/content/107/24/3109.full#ref-9.
9 Physical Activity, Physical Fitness and Longevity. - PubMed - NCBI." National Center for
Biotechnology Information. Accessed June 24, 2015. http://www.ncbi.nlm.nih.gov/pubmed/9177581?
dopt=Abstract.Exercise Slows Atherosclerosis and Stabilizes Plaque | Articles." Corporate Wellness
Programs | Employee Wellness Plans and Health Assessment - Wellsource. Accessed June 24, 2015.
http://www.wellsource.com/articles-mhc/Exercise-Slows-Atherosclerosis-and-Stabilizes-Plaque.html.

10 Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular
Disease." Circulation. Accessed June 24, 2015.
http://circ.ahajournals.org/content/107/24/3109.full#ref-9.
11Exercise slows Atherosclerosis and Stabilizes Plaque | Articles." Corporate Wellness Programs |
Employee Wellness Plans and Health Assessment - Wellsource. Accessed June 24, 2015.
http://www.wellsource.com/articles-mhc/Exercise-Slows-Atherosclerosis-and-Stabilizes-Plaque.html.

4. Discussion and Conclusion

The risk factor concept is firmly established in public health, in clinical medicine, and
in public perception. The role of the major risk factors as causal is also firmly
established. Persuasive evidence indicates that modification of major risk factors
reduces risk of coronary heart disease. Primary care and specialist physicians have
accepted responsibility and for mnaging patients at high risk with techniques known
to be effective in modifying risk factors- diet for hyperlipidemia; diet and drugs for
diabetes; and various techniques for smoking cessation
(Pg 37 the future of risk factors and primary prevention / overview)
As seen from our results, Zumba does play an important role in reducing
atherosclerosis as this form of exercise involves the incorporation of dance moves
involves coordination and movement of the entire body, involves many muscles in
the body. According to present research done on atherosclerosis, physical exercise
is able to reduce the risk factors of atherosclerosis including elevated blood
pressure, elevated triglyceride concentrations, low high-density lipoprotein
cholesterol (HDL-C) concentrations, and obesity. 12
However, due to the prevalence and length of time atherosclerosis takes to develop,
an exercise program like Zumba will require a very long term of follow up. A large
number of people will be needed to be involved to attain clinically or statistically
significant results so as to show the success in reducing risk of atherosclerosis.

12 Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular
Disease. (2003, June 24). Retrieved June 14, 2015, from
http://circ.ahajournals.org/content/107/24/3109.full.pdf