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Exercise
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The benefits of regular exercise are well documented, and regular exercise has a significant impact on morbidity and mortality from coronary artery disease (CAD). A high fitness level is a powerful predictor of mortality with fitter individuals having a 20% to 55% reduction in mortality. In addition, the heart attack survivor who participates in a regular exercise program may lower the risk of a second heart attack as much as 78%. A more important fact is that in addition to the positive impact of regular exercise on cardiovascular function, regular exercise has a significant relationship to the other modifiable risk factors. Blood pressure is better controlled, blood lipids tend to normalize, type II diabetes is better controlled, and body fatness is reduced. Thus, regular physical activity or a structured exercise program is a very powerful intervention in the primary and secondary prevention of CAD.
Thus, while regular exercise can have a significant impact on the control of heart disease, starting and maintaining a regular exercise program requires a good deal of motivation and stick-to-itiveness.
The important components of health-related fitness are the following:
- cardiovascular endurance
- muscular strength & muscular endurance
- flexibility and joint range of motion
- body fatness & lean body mass
While cardiovascular endurance may be the most important component for most people, each of the other areas can play a significant role in overall health and particularly in a person's functional ability. For example in the older population, lack of muscular strength and joint range of motion may greatly limit activities of daily living. Regular exercise can prevent a good deal of these limitations. Thus, a complete exercise program should include exercise routines for each of the above components.
Cardiovascular (aerobic) exercises improve the ability of the heart and vascular system to transport oxygen to the active organs and tissues of the body. Aerobic exercises can include walking, jogging, swimming, rowing, cycling, hiking, cross-country-skiing, rope skipping and vigorous dancing. Exercises for muscular strength and muscular endurance include lifting weights or using rubber stretch bands for resistance. This so-called "resistance training" increases both the overall strength and endurance of the specific muscles used in the training exercises. Increased strength and endurance enables one to successfully complete particular tasks with less fatigue. Flexibility and joint range of motion is accomplished by doing a good stretching routine for the various muscles and joints of both the upper and lower body. Again, improved flexibility and joint range of motion enable one to complete routine tasks in a more effective manner. Both a good aerobic workout and resistance training can have a significant impact on body fatness and lean body mass. A low body fat and a higher lean body mass have a favorable impact on blood lipid values, blood pressure and blood glucose control.
The specific type of exercise program one undertakes depends upon one's health, current fitness level and exercise goals. You should work with your doctor and other professionals to develop and try achieve to your personal goals in a safe, effective manner.
Some specific Do's and Don'ts:
- Seek professional advice on equipment and training concepts
- Develop a regular SCHEDULED exercise time
- Find a partner or group support
- Set realistic short-term and long-term goals and remember change takes time
- Start slowly and progress gradually
- provide for early success
- moderate level of intensity is the early choice
- move more, Sit less
- Chose types of aerobic exercise you like and ones that your body tolerates without increased musculoskeletal discomfort
- exercise at a moderate or "comfortable push" level of intensity
- establish a pulse rate at your "comfortable push" level and use this pulse rate for other exercise modalities and activities
- as a guide, your pulse will increase in the range of 20-50 beats per min above the resting pulse depending on medications and your "comfortable push" level
- as the exercise becomes easier, gradually increase the duration and intensity to maintain the previous "comfortable push" level
- strive for a continuous duration of 30-45 minutes on one or a combination of aerobic exercise modalities as you improve your exercise tolerance
- try to have a structured exercise routine 3 days per week and try to be more physically active on the other days
- Complete an exercise with weights or rubber stretch bands for each of the major muscle groups of the legs, arms, back and abdominals
- use a weight or resistance that you can lift 12-15 times
- increase the weight 2-5 lbs when you can lift the previous weight more than 15 times very comfortably
- remember to breathe, No breath holding when lifting weights
- Alternate aerobic modalities on a regular basis if possible to prevent boredom and nagging overuse injuries
- Decrease your caloric intake and increase daily activities if you want to lose body weight (body fat)
- Drink adequate fluids (water or sports drinks) before, during and after exercise
- Contact your doctor if you have any chest discomfort, unusual shortness of breath, increasing fatigue, or musculoskeletal discomforts as you gradually increase or continue an exercise routine
- Don't buy into the NO PAIN, NO GAIN
- stay in the "comfortable push" zone
- Don't give up after the first 2-3 sessions if you are stiff, sore and/or fatigued
- consider if you are pushing too hard
- joints and muscles will soon adjust
- Don't expect results overnight, an easy way or "magic pill"
- Don't give up if you are frustrated that changes are going too slow
Resources:
John Muir Health offers an exercise program for those with heart disease or those at high risk of developing heart disease:
Cardiac Rehabilitation
Medically supervised cardiac rehabilitation programs are offered to improve
cardiovascular fitness and awareness in individuals who have heart or blood
vessel disease and to help those who are at high risk of developing circulatory
disease. Physician referral is required. Offered at the following locations:
(925) 674-2200 - John Muir Medical Center, Concord Campus
(925) 947-5254 - John Muir Medical Center, Walnut Creek Campus or John Muir Outpatient Center, Tice Valley/Rossmoor
[$Fee] (May be covered by insurance)