Cardiac Exercise with Heart Disease
Dr Andrew Maiorana talks about exercising when you have heart disease.
We've known for a long time that regular exercise is important for reducing the risk of heart disease. It's now apparent that exercise is also very important in managing the health of people with an existing heart condition. This is somewhat of a change in policy because for a long time, people with heart conditions were advised to avoid exerting themselves. However, research over the past 20 years has consistently shown that moderate physical activity and appropriately prescribed exercise are safe for heart patients who are medically stable, and the benefits far outweigh the risks. Obviously if you develop any symptoms like chest pain, difficulty breathing, dizziness, nausea or excessive sweating, stop the activity and rest. If the symptoms persist beyond10-15 minutes, it's important to seek medical attention.
There are many benefits of being physically active. In addition to feeling fitter and stronger, exercise helps improve many of the risk factors that contribute to heart disease, including lowering blood pressure, better control of blood lipids and cholesterols, and improved insulin resistance and glucose tolerance, which are important in diabetic health.
Exercise also complements a healthy diet in managing body weight. Importantly, every time we exercise the blood vessels open up. With regular exercise, the body develops a much greater capacity to provide blood flow to the muscles of the body, including the heart muscle.
All of these factors contribute to an improved prognosis, meaning that people with heart conditions who exercise regularly live longer lives and are less troubled by symptoms.
Some people avoid exercise because they don't know how much they should do. There are some very simple guidelines to follow to make sure the exercise you do is safe and effective. These can be used by healthy people starting an exercise program, as well as those with heart conditions. These guidelines relate to endurance type activities, such as walking or cycling, which are the best forms of exercise for heart health and fitness. Always start gently and build up gradually. 10 minutes twice a day is a good starting point, but some people may wish to commence at an even lower level than this. When you're comfortable with this initial level, start increasing the duration of exercise gradually, building up to at least 30 minutes on most days. This might take quite a few weeks for people who are unfit or who have had recent heart problems. For people who are finding it difficult to increase their exercise time, the 30 minutes doesn't need to be done all at once. It's ok to have a rest every 10 minutes or so if you need to.
An appropriate level of exercise should make you breathe a bit heavier, but not so fast that you can't still carry on a conversation. You might feel some fatigue in your muscles, but you shouldn't get exhausted. It's quite normal to work up a bit of a sweat when you're exercising, so drink enough water to replace the sweat that you've lost.
In addition to endurance exercise, lifting some light weights is also useful to help keep the muscles strong and in good condition. An appropriate weight for a given exercise is one that can be lifted at least 15 times with a good technique and without having to strain. If you plan to start weightlifting, it is better to do so with the help of an exercise professional, at least to start with, to make sure you're getting the technique right.
It is also important to be as physically active as possible in your daily life, doing tasks like housework, gardening and casual walking. While these activated might not necessarily replace formal exercise, they are certainly complementary, so look for opportunities in everyday life to be as physically active as possible.
There are many exercise groups available in the community to help people become more active. The National Heart Foundation will have a list of services in your local area that might suit you. Another option is talking to you GP - they may be able to refer you to someone who can work out an exercise prescription that will work for you, and it is important to get a check up before starting any new exercise program.
For more information, see Physical Activity with Cardiovascular Disease.
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