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Exercise and Heart Health

Over the past several years, we have been instructed on the value of exercise and activity for our heart health. Statistics on the state of heart health in the US are sobering1:

  • In the US, over 2000 people die from heart related illnesses every day (about one every 40 seconds)
  • Every year over 735,000 Americans have a heart attack or myocardial infarct (MI) and of these, over 500,000 are ‘first’ heart attacks
  • Coronary artery disease, the prime cause of MIs kills over 370,000 people every year
  • The direct and indirect costs of cardiovascular diseases and stroke total more than $320.1 billion annually

Peer reviewed data have established that regular exercise reduces risk of heart disease and also increases survival after a heart attack so there is little argument against the benefits of physical activity; the question of how much activity a heart requires to remain healthy, particularly after a heart attack, was unknown. Analyzing retrospective data of over 2000 adults who had undergone previous stress tests and later had heart attacks, researchers from Johns Hopkins in Baltimore and Henry Ford Health Systems in Detroit, found those who engaged in less exercise following a first heart attack led to increased risk of dying within 365 days after their MI. 2 The majority of the participants in this study were in their early 60s and less than half were women. The researchers concluded there was something about being more physically fit prior to their MI that helped protect the survivors a year later.

Many studies have shown physical fitness may help reduce the risk of a first heart attack. After a heart attack, increasing fitness levels have also been shown to improve long term health outcomes. The best way to increase fitness level is through regular physical activity and exercise training. Healthcare providers recommend people aim for 75 minutes of vigorous activity a week, or 150 minutes of moderate activity, or some combination of the two. In the publication from the Henry Ford Health Systems and Johns Hopkins, researchers showed greater improvements in fitness were obtained with more intense interval training. Their paper emphasized cardiorespiratory or aerobic fitness but muscular fitness and muscular strength from resistance training plays a key role as well– more so in older people. Core strength and balance are also very important in the older population.

Recently, the Cleveland Clinic undertook a survey to assess how much exercise is necessary to protect the heart muscle and also evaluated how fitness-savvy people are (or aren’t) when it comes to heart health. 3 The results revealed that 40% of Americans were exercising lessthan the recommended 2.5 hours a week (150 minutes) of moderate aerobic exercise, and only 20% actually knew how much exercise is recommended for a healthy heart. The major reasons why people were not exercising? Over 40% said work precluded them from going to the gym, 37% indicated they were ‘too tired’ and 28% stated that prior commitments with family or friends superseded their exercise routine.

Over 40% said work precluded them from going to the gym, 37% indicated they were ‘too tired’ and 28% stated that prior commitments with family or friends superseded their exercise routine.

Dr. Steve Nissen, chair of cardiovascular medicine at the Cleveland Clinic, has said that a little exercise can go a long way and potentially reducing the risk of dying from heart disease by as much as 40-50%; it’s certainly worth making time for –particularly in our aging population. Lifestyle changes including dietary changes and exercises will boost blood flow and lead to lower blood pressure, improve sleep and increase overall wellbeing.

It’s imperative to remember that all heart patients should consult with their physicians before embarking on a new fitness program but it’s important to remain active even in the rehabilitation phase following a heart attack.

References:

1. http://www.cdc.gov/heartdisease/facts.htm

2. Shaya GE, Mouaz HA, Hung RK et al, Mayo Clinic Proceedings, Vol 91; Issue 2, 129-139; Feb 2016

3. http://health.wordpress.clevelandclinic.org/wp-content/uploads/sites/3/2016/01/Exercise-and-Heart-Health-Love-Your-Heart-Cleveland-Clinic.pdf

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