REGULAR EXERCISE LEADS TO A HEALTHY HEART

The answers to several questions about how to exercise for a healthy heart.

Not so long ago, we used to think that exercise was probably beneficial for cardiovascular health and the health of the heart and blood vessels. Now we know that regular physical activity is as important for heart health as the other three major lifestyle factors: quitting smoking, lowering blood cholesterol and controlling blood pressure.

What kind of exercise is best?

Regular physical activity is best. In other words, it’s not so much the kind of exercise that is important, but the fact that you do something several times a week, week after week, month after month and year after year. Studies show that as little as 30 minutes a day of moderately vigorous physical activity, such as walking, yard-work, housecleaning or climbing stairs, significantly reduces your risk of heart disease. Best of all, exercise need not be extremely vigorous to be beneficial to your health. Find activities that are convenient and fun, and make them a regular part of your life.

Why does exercise help?

Exercise helps to control blood pressure, and improve cholesterol, fat and blood sugar metabolism. It prevents obesity, slows the clotting rate of the blood and reduces stress. All of these things help to prevent artery disease, or atherosclerosis. Atherosclerosis is marked by a gradual build-up of deposits, called plaque, on the artery walls. Unstable plaque can eventually break off and trigger the formation of blood clots, which may block blood flow. This blockage can cause a heart attack if it occurs in the arteries feeding the heart, or a stroke if it occurs in arteries supplying blood to the brain. By slowing the rate of plaque deposition, exercise helps to keep arteries healthy.

Can’t exercise be dangerous for some people?

Very rarely, strenuous activity can precipitate a heart attack. This is most likely to occur in someone with artery disease, or some other heart problem.

How do you know if you have artery disease? Unfortunately, there is no good way to know. Exercise stress tests can be helpful, but are expensive and not always accurate, causing alarm and further invasive testing in many healthy people who get false positive readings. Nevertheless, they are recommended for men over 40 and women over 50 who have been inactive and are starting a program of strenuous physical activity. They are also recommended for people with two or more cardiovascular risk factors, such as high cholesterol, high blood pressure and so forth, and for people who have experienced symptoms such as chest pain that might indicate heart disease.

To make your workouts as low-risk as possible, use the following guidelines:

1) Ask your doctor if you need a stress test, or whether you should follow any special exercise guidelines.

2) Exercise regularly. Exercise is much safer for people who exercise routinely.

3) Warm up and cool down. A slow but steady building of exercise intensity during a warm up allows the cardiovascular system to adjust to the increasing demands of exercise, and a good cool down helps it adjust back to resting level.

4) A mild to moderate exercise intensity is safer than a more vigorous workout.

5) Listen to your body and heed warning signs of cardiovascular disease, such as chest pain or pressure, abnormal heart rhythms or dizziness. While these symptoms are often caused by something other than heart disease, it is best to be safe and check them out.

To make your workouts as low-risk as possible, use the following guidelines:

1) Ask your doctor if you need a stress test, or whether you should follow any special exercise guidelines.

2) Exercise regularly. Exercise is much safer for people who exercise routinely.

4) A mild to moderate exercise intensity is safer than a more vigorous workout.

Does regular exercise guarantee a healthy heart?

My brother runs more than 40 miles a week, but has occasional chest pain. He attributes it to stress, and says he can’t possibly have heart disease since his fitness level is so high. Is this true?

Many people mistakenly believe that regular vigorous exercise will make them immune to heart disease. Physical fitness reduces, but does not eliminate, cardiovascular risk. Heart disease can occur even in people with no risk factors. While stress can be the cause of chest pain, it’s important not to rule out heart disease just to be on the safe side.

Barbara A. Brehm, Ed.D., is professor of exercise and sport studies at Smith College, Northampton, Mass.

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