Exercising With Heart Disease

Coronary heart disease is the most common form of cardiovascular disease and the leading cause of death in the U.S. and worldwide. It results when fatty material in the coronary arteries blocks the flow of blood to the heart muscle. If the blood flow can’t meet the demands of the heart, a person often feels chest pressure or a dull ache, sometimes radiating up into the neck, jaw, left shoulder or arm. This type of pain is referred to as angina. Clots may form and completely close the vessel, resulting in a heart attack. More than 1 million Americans suffer a heart attack, or myocardial infarction (MI), each year.

A regular exercise program and a healthy diet after MI can save your life. Research suggests that exercise reduces death both from cardiovascular causes and in general. Further, the atherosclerotic process is slowed, and the risk of having another cardiovascular event (such as an MI) or hospitalization is decreased. But doctors often aren’t appropriately trained nor blessed with the extra time to provide extensive nutrition and exercise recommendations, which is why cardiac rehabilitation centers are available to provide nutritional advice, guidance about weight management and exercise prescription.

If you’ve recently had a heart attack, have chronic angina (persistent chest pain), had a stent placed, underwent coronary artery bypass graft (CABG) surgery, had a heart valve replaced, have chronic heart failure or received a heart transplant, your physician should refer you to a cardiac rehabilitation program; however, only 10 to 20% of appropriate candidates in the U.S. get this critically important referral. Part of the reason is due to geographic availability, or lack thereof. Part is due to physician failure to refer—particularly for women and the elderly. If you think that you should be eligible for cardiac rehabilitation, consult your physician for advice on the best type of program based on your medical history and present physical condition. Keep in mind that some people can safely start an exercise program at home or on their own.

Once your physician has cleared you to exercise on your own or with a qualified trainer, you should follow a program that will best help you to meet your health and fitness goals. Following are some guidelines to help you to optimize your exercise time as well as your health and safety:

Include at least a five-minute warm-up and five-minute cool-down in every exercise session to reduce the likelihood of oxygen deprivation to the heart in response to a sudden physical effort or abrupt cessation of exercise.Engage in moderate-intensity physical activity such as brisk walking for at least 30 minutes on most, preferably all, days of the week.Monitor your exercise intensity closely. Make sure to stay within your individual heart-rate zone (usually determined from a treadmill test under the supervision of a physician).Be cautious about engaging in vigorous physical activity. If you plan to begin a vigorous program, discuss it thoroughly with your physician. Also be sure to complete an exercise stress test first.Avoid strenuous activity in extreme environmental conditions. Vigorous exercise in the cold (such as snow shoveling) is associated with MI. Hot conditions require a dramatic increase in the heart’s workload. High altitude increases demands on the heart, particularly for individuals who are not acclimatized.Inform your trainer and physician if you have any abnormal signs or symptoms before, during or after exercise. These include chest pain, extreme fatigue, indigestion or heartburn, excessive breathlessness, ear or neck pain, upper respiratory tract infection, dizziness or racing heart and severe headache.If prescribed, always carry your nitroglycerin with you, especially during exercise.Never exercise to the point of chest pain or angina. If you develop chest pain during exercise, call 911 immediately.Make sure the facility where you exercise is well-equipped in case of an emergency. Ask the managers if the facility has an emergency response plan and an automated external defibrillator (AED) (with staff trained on how to use it) on the premises.

It’s never too late to start an exercise program or increase physical activity. In fact, combined with a healthy diet, it’s the best choice you can make for your heart health. Work closely with your physician and other healthcare providers to start slow and gradually increase your exercise frequency and duration. And know that if you ever need an extra hand, you can find an ACE-certified Advanced Health & Fitness Specialist in your area.

American Heart Association: www.americanheart.org/
Medline Plus—Heart Disease: http://www.nlm.nih.gov/medlineplus/heartdiseases.html/
WebMD—Heart Health Center: http://www.webmd.com/heart/

View the original article here

Exercising in the Cold

The biggest concern for exercising in the cold is hypothermia, or too much heat loss. When you exercise in a cold environment you must consider one primary factor: How much heat will your body lose during exercise?

Heat loss is controlled in two ways:

Insulation, consisting of body fat plus clothingEnvironmental factors, including temperature, wind and whether you’re exercising in the air or in the water. Each of these factors plays a role in the body’s ability to maintain a comfortable temperature during exercise.

 Although many people aspire to have a lean figure, people with a little more body fat are better insulated and will lose less heat. Clothing adds to the insulation barrier and is clearly the most important element in performance and comfort while exercising in the cold. Generally, heat loss from the head alone is about 50% at the freezing mark, and by simply wearing a helmet or hat, a person can stay outside indefinitely.

Clothing is generally a good insulator because it has the ability to trap air, a poor conductor of heat. If the air trapped by the clothing cannot conduct the heat away from the body, temperature will be maintained. Unlike air, however, water is a rapid conductor of heat and people will sweat and risk significant heat loss even in the coldest of temperatures. With this in mind, you want to choose clothing that can trap air but allow sweat to pass through, away from the body.

By wearing clothing in layers, you have the ability to change the amount of insulation that is needed. While many new products can provide such a layered barrier, it is important to avoid heavy cotton sweats or tightly woven material that will absorb and retain water. Because these materials cannot provide a layer of dry air near the skin, they can increase the amount of heat your body loses as you exercise.

Keeping the hands and feet warm is a common concern when exercising in the cold. Lower temperatures cause blood to be shunted away from the hands and feet to the center of the body to keep the internal organs warm and protected. Superficial warming of the hands will return blood flow to prevent tissue damage. Blood flow will not return to the feet unless the temperature of the torso is normal or slightly higher [0.5 to 1.0 degree Fahrenheit (F) above normal]. So, to keep your feet warm you must also keep the rest of your body warm at all times.

Always check the air temperature and wind chill factor before exercising in the cold. Data from the National Safety Council suggest little danger to individuals with properly clothed skin exposed at 20° F, even with a 30 mph wind. A danger does exist for individuals with exposed skin when the wind-chill factor (a combined effect of temperature and wind) falls below –20° F.

That can be achieved by any combination of temperatures below 20° F with a wind of 40 mph and temperatures below –20° F with no wind. If you are exercising near the danger zone for skin exposure, it also is advisable to warm the air being inhaled by wearing a scarf or mask over your nose and mouth.

Check the temperature and wind conditions before you go out and do not exercise if conditions are dangerous.Keep your head, hands and feet warm.Dress in layers that can provide a trapped layer of dry air near the skin (avoid cotton sweats and other similar materials).Warm the air you are breathing if temperatures are below your comfort level (usually around 0° F).

How to Exercise Safely in Cold Weather: www.sportsmedicine.about.com/cs/environment/a/aa121100a.htm
Runner’s World—Run and Race Well in the Cold: www.runnersworld.com/article/0,7120,s6-238-267-269-12331-0,00.html
Runner’s World—Is Cold Weather Running Bad for You? www.runnersworld.com/article/0,7120,s6-238-267-269-7442-0,00.html

View the original article here