What You Can Do If Heart Disease Has Slowed You Down
Reviewed by Dr. Gordon Blackburn, Program Director of Cardiac Rehabilitation, Section of Preventive Cardiology
If you’re visiting this web site, you probably are aware of the benefits that regular exercise has for the heart. Many studies show that exercise positively affects heart rate, blood pressure, and the body’s oxygen use, reducing fatal and non-fatal heart attacks as well as other cardiac problems such as arrhythmias (heart-rhythm disturbances) and thrombosis (clotting). Sound, scientific research shows us that exercise’s health benefits include better control of diabetes, obesity and cholesterol levels. Regular, aerobic physical activity has repeatedly been shown to reduce the risk of future heart attacks in both those with and without documented heart disease.
Based on such convincing data, the American Heart Association (AHA) has reached a consensus on what constitutes a healthful amount of exercise. The guidelines call for a minimum of 30 minutes (ideally 60 minutes) of aerobic physical activity performed at moderate intensity, either in one continuous period or in intervals of at least 10-minutes duration on most — preferably all — days of the week. This is the amount called for to reduce the risk of coronary disease. It is equivalent to briskly walking at least 1.5 miles per day or raking leaves for half an hour. Although any increase in activity level imparts benefit, recent research suggests that a significant cardiovascular protection is achieved when at least 1000 calories are expended in exercise/week (equivalent of walking approximately 10 miles a week). Greater cardiovascular protection is gained if the caloric expenditure increases up to 2000 kcal /week (equivalent of walking approximately 20 miles/week = 4 miles a day/5 times a week or 3 miles a day, 6–7 days a week). Beyond this level the cardioprotective benefit of exercise plateaus.
Such guidelines may seem daunting, particularly if you have already been diagnosed with heart disease. Even without a specific health challenge, many of us are so busy that it’s hard to fit the recommended amount of exercise into our day. But Cleveland Clinic exercise physiologist Gordon Blackburn, PhD, says giving up is not the answer. “Even if you can’t meet the AHA requirements, exercising still will give you benefits,” he notes. “Exercising a little bit each day is better than not exercising at all.”
“In a way, it’s kind of the same situation as with smoking,” Dr. Blackburn continues. “For example, if you must smoke, smoking three cigarettes a day is better than smoking three packs a day, even though the best thing for your health would be to quit completely.”
If you are unable to follow the AHA guidelines because of cardiac problems, Dr. Blackburn suggests getting what’s called an “exercise prescription.” Exercise can be – in fact should be – tailored to your own individual situation, just like other health programs. After all, a patient with a low-density-lipoprotein (LDL) cholesterol of 140 mg/dl is not prescribed the same medication dose as someone with an LDL cholesterol of 180 mg/dl.
You can get an exercise prescription from a cardiac rehabilitation specialist, usually an exercise physiologist. He or she, in consultation with your cardiologist, can put together a highly individualized program that takes into consideration your specific cardiac problem, your age, and stage of recovery. For example, someone who has mild-to-moderate heart failure may be advised to start a walking program but to walk only a few blocks or just a few minutes and repeat the activity several times a day. Someone else who had bypass surgery a couple years ago and participated in a cardiac rehabilitation program afterwards and continues to do well may be advised to perform a more vigorous activity program of longer duration.
“We try to set exercise prescriptions based on accepted guidelines,” Dr. Blackburn explains, “but at the same time, we work with the patient to help get them to their optimal activity level over time. The patients find that, as they follow their prescription, they get stronger and feel better as a result of the exercise. This allows us to increase the amount and duration of exercise as their health improves.”
Don’t let poor health or lack of time rob you of a plan for physical exercise. The improvements you’ll experience — in physical, mental, and emotional health — are well worth the effort.
To make an appointment with an exercise specialist or to join a cardiac rehabilitation program, contact the Cleveland Clinic Preventive Cardiology - 216.444.9353 or 800.223.2273 ext. 9353.
For more information:
To read the AHA guidelines in detail, see:
Paul D. Thompson, MD; David Buchner, MD; Ileana L. Piña, MD; Gary J. Balady, MD; Mark A. Williams, PhD; Bess H. Marcus, PhD; Kathy Berra, MSN, ANP; Steven N. Blair, PED; Fernando Costa, MD; Barry Franklin, PhD; Gerald F. Fletcher, MD; Neil F. Gordon, MD, PhD; Russell R. Pate, PhD; Beatriz L. Rodriguez, MD, PhD; Antronette K. Yancey, MD; Nanette K. Wenger, MD . Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease: A Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity) Circulation.* 2003;107:3109.