Exercise
Our bodies were meant to move. If they weren't, we wouldn't be built as we are and would look more like a turtle or hippo! Sedentary lifestyles go hand in hand with unhealthy diets and numerous cardiac risk factors.
You are sedentary if you:
- Do not take time to exercise 30 minutes at least three times weekly.
- Have leisure-time activities that do not require you to move from place to place.
- Seldom walk more than one block each day.
- Spend most of your day sitting
- Have a job that is inactive.
Physical activity is a prime example of how risk-reducing
behaviors have multiple 
benefits.
In addition to improving cardiovascular health, regular exercise
promotes weight loss, helps lower blood pressure and enhances
the body's ability to eliminate cholesterol and other fatty
substances. It even reduces the lifestyle-limiting effects
of osteoporosis and arthritis, improves mental health and
helps us remain independent as we age, improving the quality
of life. In other words, it delays the onset of, and reduces
the severity of, the natural consequences of aging.
What does exercise do to improve cardiovascular health?
In addition to helping out the heart, exercise affects numerous other risk factors. Benefits include:
- Increasing the ability of your heart to pump blood
- Decreasing the heart rate
- Decreasing blood pressure
- Increasing HDL cholesterol level
- Helping to control and maintain weight
- Helping to reduce stress
- Reducing elevated levels of blood sugar in people with non-insulin dependent diabetes
What should I do to exercise?
Before starting an exercise program, consult your physician. According to guidelines set forth by the American Council of Sports Medicine, you may want to conduct an exercise stress test before you embark on an exercise program. You may also choose to have a simple fitness test. Both tests will provide information needed to develop an exercise prescription for you.
The traditional exercise prescription for cardiovascular health is to exercise for 30-40 minutes 3-6 times weekly at a "vigorous" pace. In addition, follow a strength and flexibility program on a regular basis. Exercise is the key to longevity. Why? Because the more time spent exercising, the greater the payoff in terms of all the benefits, including longevity.
The prescription for a traditional exercise program includes:
- A warm-up before exercise. A warm-up
is merely starting the exercise at a low intensity for the
first 5 minutes. This warm-up increases blood flow to the
muscles and joints and slowly increases the heart rate to
an exercise heart rate (instead of jumping from a resting
to an exercise heart rate, which can be dangerous).
- A cool-down after exercise. A cool-down
is a slow walk or other exercise for the final 5 minutes,
coupled with some stretches to improve flexibility. Performing
stretches as part of the cool-down allows you to increase
the movement around joints that are being stretched and
is integral to an exercise prescription.
- 30-40 minutes (not including warm-up and cool-down)
of moderate to high intensity aerobic activity (briskly
walking, running, cycling, swimming) 3 to 6 times weekly.
Aerobic activity is defined as activity in which large muscles
are used repeatedly to perform work. Since these large muscles
need oxygen to contract, the heart rate increases to send
more blood and oxygen to the working muscles. This is also
called the cardiovascular component of exercise and provides
all the "good for your heart" benefits of exercise.
- A target heart rate. This is the heart
rate that should be achieved when exercising. This is calculated
based on exercise stress test or fitness test results. Typically,
when the target heart rate is achieved, benefits of exercise
are maximized. Another guide to use that corresponds to
target heart rate is the "talk test". While exercising you
should be at a slightly breathless pace. You should be able
to carry on a conversation with someone exercising next
to you, yet not be so out of breath that you can't talk.
- Strength training is the final component to an exercise prescription. Patients in the Cardiac Rehabilitation Program at the Inova Heart Center perform strength training exercises after the cardiovascular component of exercise. Strength training helps increase muscle mass and maintain bone density. It allows us to do more work because of increased strength. Strength training should always begin under the supervision of an experienced trainer, and it should always be avoided during the recovery phase of heart disease.
What else can I do?
A
recent recommendation in the literature is that every adult
accumulate 30 minutes or more of moderate intensity physical
activity (to include recreational walking or gardening) on
most, preferably all, days of the week. The recommendations
are based on evidence that health benefits are gained from
any increase in physical activity. But please remember that
these recommendations are meant to complement, not replace,
the traditional exercise prescription. Moderate to vigorous
exercise will provide more health benefits in the long run.
Here are some principles to get you started with some moderate activities on days you are not following your traditional routine:
- Play around. Choose a sport that you enjoy and get back
into it. Dance, bike, play in the water or snow, run with
the dogs.
- Find an interest. Become an expert on something you've
always been interested in. Take a hike, go to the museum
or on a day trip, garden, take an active vacation, explore
architecture or bird watching.
- Use diversion. Exercise with a friend, take a fitness
class, find methods of entertainment while you work out
(a walkman, book, tape or TV while using stationary equipment),
play mental games, solve problems, fantasize.
- Spice it up. Regularly vary your type of exercise, time of day, route, improvise (walk to a destination or way to a destination).
Should exercise cause discomfort?
Call 911 or (if it is not an emergency) your physician if your have any of the following symptoms:
- Chest discomfort or pressure
- Severe shortness of breath
- Burst of a very rapid or irregular heart rate
- Feeling of faintness (be sure you have replaced needed fluids)
