Exercise and Cardiovascular Concerns

Cardiovascular disease (CVD) still ranks as Americans #1 killer claiming the lives of nearly 40% of the nearly 2.4 million American who die each year. It is estimated that 61.4 million Americans have some form of CVD. Americans will pay about $330 billion in 2002 for CVD medical costs and disability. These numbers are expected to steadily grow over the next few years as the baby boomers age and due to the national crisis of obesity. It is also a known fact that a high percentage of those that have suffered from one heart attack will repeat. This is because we are creatures of habit and return to the bad habits (poor diet, lack of exercise, smoking) soon after we recover and feel better. Making lifestyle changes is the best way to prevent and decrease your risk for CVD. Regular exercise is one of those changes. There are however, a few important guidelines to follow when exercising with CVD.

First and foremost you will need to receive medical clearance from your doctor which releases you from medical supervision and allows you to begin unsupervised exercise at home or in the community. Usually the first 4-12 weeks after a heart attack you will be participating in a cardiac-rehab program with medical supervision. Once released you will also be given target heart-rate parameters to follow from your doctor, exercise physiologist or rehab professional. Follow these parameters closely rather than using target heart-rate formulas, such as Karvonen, because you may be on medicine that suppresses your heart-rate (beta-blockers).

It's advisable to minimally keep track of perceived exertion level, heart rate and any unusual signs or symptoms during each exercise session. Record these parameters in your exercise log to help you monitor your progress and achieve a safe exercise level. Stop exercising immediately if your heart-rate drops more than 10 beats per minute, when the workload hasn't changed or has increased, or if your blood pressure exceeds 220/110 at anytime while exercising. Other signs and symptoms that point to cessation of exercise are: if you feel nausea, confusion, light headedness, over-fatigue, unnatural paleness, dizziness or fainting, chest pressure or pain, sudden or severe shortness-of-breath, irregular heart rate or perceived palpitations.

Besides monitoring your vital signs, there are other important guidelines to follow when exercising with CVD. Include an adequate warm-up and cool down period in each exercise session. Approximately half of all exercise related cardiac complications occur immediately after exertion and by cooling down gradually you can minimize this risk. Avoid saunas, steam baths, and hot tubs as they can cause dehydration. Try to refrain from doing isometric exercises, lifting heavy weights, holding your breath, straining or overgripping. Beginners should start with low weight and high reps (repetitions) and progress slowly (no more than 10% per week). During cardiovascular training do not perform excessive overhead work, avoid anaerobic exercises, and don't use extrinsic resistance (ankle, hand or wrist weights). By following these guidelines and exercising regularly you are on your way to achieving greater health and wellness.

by Carol Glasscock, MS,PT