The Power of Exercise: How Exercise May Help Prevent and Treat Heart Disease

 

by Janis Jibrin, M.S., R.D.

He was playing his saxophone in the Birmingham Alabama church orchestra when the first signs of trouble developed: a pulsating jaw and intermittent back pain. A little while later, sitting in the passenger seat of his car, a cold clammy sweat broke out and his arm started tingling. “I’m having a heart attack, get me to the emergency room,” he said to his wife. He was saved in the nick of time by an experimental shot that dissolves clots. Rick Vinson, an associate church pastor and branch director for the Birmingham News, was just 43 years old.

 

   
   
Related Topics:
     

The Power of Prevention

     

The Power of Cardiac Rehab

     

How Much Exercise Do You Need

     

Get Your Exercise Routine Started

   

Eleven years, ten stent operations, another heart attack, and a diagnosis of type 2 diabetes later, Rick finally decided to take charge of his health and went to cardiac rehab. “I went after the first heart attack but didn’t take it seriously. But this time, it really clicked. I took to heart what the rehab coach told us: ‘You can take an hour and half daily now to change your lifestyle or never have another hour and half to do anything.’ When my attitude shifted, rehab wasn’t so hard,” says Rick.

 

He dropped 20 pounds in the nine-week rehab program, sending his scary-high LDL (“bad” cholesterol) and triglycerides (another destructive blood fat) into the normal range. After rehab, he continued walking four to four and half miles daily and another eight pounds dropped off, and he cut his diabetes medication dosages in half.

 

The much-improved lab values indicate that Rick is saving his life—literally. We’re going to help you get on the same path as Rick, whether you have heart disease or are simply trying to prevent it.

 

The Power of Prevention

 

If you don’t yet have heart disease, exercise and a heart healthy diet may help slash risk of developing the condition by a whopping 74 percent, according to some estimates.1 Exercise by itself is also powerfully protective; one recent scientific review found that the least fit people may have a 56 percent greater chance of developing heart disease compared to the fittest people and a 47 percent greater likelihood compared to those with “intermediate” fitness.2 (Fitness was measured by “cardiorespiratory fitness,” the ability of your circulatory and respiratory systems to fuel you during sustained physical activity.)

 

How does exercise help protect your heart? “It launches a multipronged attack on factors contributing to heart disease,” says Haitham M. Ahmed, MD, MPH, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD. Dr. Ahmed recently reviewed the science on exercise and heart disease for the American Journal of Cardiology.3 Here are some highlights:

 

  • Exercise helps send blood fats in the right direction. It can help reduce the types that contribute to clogged arteries: LDL and triglycerides. “Exercise can change the type of LDL, converting it to the “lower-density” type that is less risky to the heart,” Dr. Ahmed explains. Simultaneously, it can help raise HDL, the “good” type which helps remove cholesterol from the body.
  • It may help “thin” the blood, making it less likely to form clots. Clots can lodge in the arteries causing heart attacks and strokes (disruption of blood to a part of the brain). “While working out, clotting factors increase, slightly raising clot risk in people who are prone. But don’t get scared off, because consistent physical activity reduces those clotting factors over the long run,” says Dr. Ahmed.
  • It may help reduce systemic inflammation. While a little inflammation is healthy—for instance, when it’s caused by your immune cells to fight off infection—chronic or systemic inflammation can be destructive, and may increase risk of heart disease.
  • It may make your blood vessels more pliable. This means your vessels can better relax and open, which may help lower blood pressure. However, the research is still not clear how much of an
  • It may help you shed body fat, which, in turn, not only may help reduce LDL and triglycerides, but may also help bring down two other risk factors: high blood sugar and high blood pressure.

And you don’t need a scientist to tell you about some of exercises’ other side effects. “I have so much more energy now. And I’m not vain, but I do feel better up in front of the congregation without a big protruding belly,” laughs Rick Vinson.

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The Power of Cardiac Rehab

 

For all the same reasons exercise may help prevent heart disease, it may also help out your heart if you have the condition.4 That’s why cardiac rehab—of which exercise is a big component—is so crucial. Rehab programs differ, but most include counseling on diet and stress management and offer on-site workouts. "If you already have heart disease, rehab can help slow the progression of your disease, and may even help reverse it a little. If you’ve had a heart attack, it can reduce your chances of dying from heart disease by up to 35 percent,” says Vera Bittner, MD, M.D., section head, Preventive Cardiology and medical director of the University of Alabama at Birmingham cardiac rehab program—the same one that helped Rick Vinson turn his health around.

 

Yet, she says that only about 20 percent of people who need rehab get it. “There are lots of reasons—maybe their doctor didn’t prescribe it, their insurance doesn’t cover it, there’s not a center close by, or they enrolled but dropped out,” explains Dr. Bittner.

 

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How Much Exercise Do You Need

 

While any amount of physical activity is better than none, the leading health authorities (American College of Sports Medicine, U.S. government’s Dietary Guidelines, and others) recommend the following (or something very close). No matter how much exercise you plan on getting, be sure to get your healthcare provider’s approval before beginning any new exercise program.

 

Aerobic (cardio) exercise:

This type of exercise includes walking, jogging, biking, working out on an elliptical machine—any exercise that gets your heart pumping and lungs working a little harder. Check out our Exercise Articles for cardio workouts and a week-by-week plan.

 

These exercise guidelines are for healthy adults.5 Work up to these goals at your own pace, always challenging yourself. If you have heart disease or another condition, consult with your doctor on what level is best for you. Some people with heart disease may be able to follow these guidelines under the supervision of their doctor; others have to take it down a few notches.

  • To help prevent heart disease and other chronic conditions, aim for at least 150 minutes of moderate intensity exercise per week, preferably spread out over five days (for instance, five, 30-minute sessions per week).

or

  • Log in at least 75 minutes of vigorous exercise per week, done on at least three days of the week.

If you need to lose weight, 150 to 250 minutes of moderate intensity exercise (or half that amount of vigorous exercise or some combo of the two) per week will most likely result in modest weight loss.6 But if you push it past 250 minutes weekly, you should see significantly more pounds shed. And 150 to 250 minutes weekly can also help you maintain body weight after a weight loss, although more minutes are even more effective.

 

Strength training 5: Free weights, machines or exercise bands all do the same thing: Make you stronger, give your body a more toned look, and help fight the shrinking lean body mass that comes with age. For examples of strength training moves, check out the Center for Disease Control’s site. It was designed for older people but the exercises (click through all four stages) are appropriate for all ages.

  • Do exercises for both upper and lower body, two to three times per week
  • Do two to three sets per exercise
  • Aim for 10 to 12 repetitions per set.

Flexibility training (stretching) 5: These exercises can improve posture, stability and balance, but it’s not clear whether they have any link to heart disease prevention.

  • Do these at least twice a week; you’ll see the greatest gains if done daily.
  • Hold your stretch for 10 to 30 seconds, until you feel slight discomfort. Older folks may see even more improvements in range of motion if stretches are held for 30 to 60 seconds.

Check out our Exercise Articles to put these guidelines into action with a week-by-week fitness plan. No matter what your fitness level, this plan will make you fitter and stronger.

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Get Your Exercise Routine Started

 

If you’re like the 30 percent of Americans who don’t do any exercise at all, or even the 18 percent who clock in just 30 minutes one or two days a week 7, then the exercise recommendations above may seem about as realistic as winning the lottery. But for every obstacle or excuse, you can usually play devil’s advocate and come up with a way you could get out there and move. (As in: “I commute so I can’t walk to work.” “So? Walk at lunch.” Or: “I’m too busy.” “You could drop a few hours of TV and Internet surfing.” That’s the type of dialogue you need to have with yourself.

 

And don’t let the specter of 150 minutes scare you. If you’re very out of shape, it could take many months to reach this goal. That’s perfectly OK. As long as you’re progressing, you’re taking the right steps toward starting to help protect your heart and health.

 

You also have to tap into what motivates you. No one’s motivated to exercise every minute or every day. But something has to get you out the door walking, or on the treadmill or doing some sort of physical activity 150 minutes weekly. “Sticking around for my wife of 32 years, my three daughters and my grandchildren, helps keep me motivated. Also, just feeling so much better is motivation in itself,” says Vinson.

 

Sure, there are a lot of obstacles to exercise, but the truth is, the reasons to do it are more compelling. Consult your health care provider to determine a safe level of exercise for you.

See also:

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References

1 Nurses Health:  Hu, FB and Willett, WC. Optimal diets for prevention of coronary heart disease.  JAMA, November 27, 2002—Vol. 288, No. 20.
2 Kodama S, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women. Journal of the American Medical Association. 2009;301:2024.
3 Ahmed, HM, et al. Effects of Physical Activity on Cardiovascular Disease. Am J Cardiol. 2012;109:288–295.
4 Heran BS, et al. Exercise-based cardiac rehabilitation for coronary heart disease. CMAJ. 2011 March 8; 183(4): 430–436.
5 Garber, CE, et al.  Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise,  Medicine & Science in Sports & Exercise: July 2011,  Volume 43, Issue 7, pp 1334-1359
6 Donnelly, JE. Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults. Medicine & Science in Sports & Exercise: February 2009, Volume 41,  Issue 2, pp 459-471.
7 No Major Change in Americans’ Exercise Habits in 2011.  Gallup Wellbeing. http://www.gallup.com/poll/153251/No-Major-Change-Americans-Exercise-Habits-2011.aspx

 

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