February is a month for our hearts.  

It is difficult to use our heart if our health is in question.  

My philosophy is to use research and implement the current knowledge and practices we have available until new research yields new and better results. Heart health is multifaceted. Therefore, I want to address some broad information about the heart which is related to exercise specific heart health knowledge.  There are many numbers used, but some are more important than others when talking about fitness. I want to discuss some of these important numbers and how they affect our hearts when exercising. After knowing the numbers and what they are describing I will explore ways to improve those numbers through various methods.  After reading this blog I hope you have an idea of where to look for accurate information, and how to use that information to make your heart healthier.

Just like other muscles of the body, the heart contracts during exercise.  The increased contraction of the heart muscle requires an increased supply of oxygen-rich blood that provides necessary nutrients.  As exercise intensity increases so does the demand for blood and oxygen to the heart muscle. If the vessels which supply the heart are narrowed from atherosclerosis, the blood supply is limited, and the increased oxygen demand cannot be met, then many things can happen.  These symptoms can result in angina, possible myocardial infarction, or heart attack.   

Cardiovascular disease (CVD) is a general term for any disease of the heart, blood vessels, or circulation.  For more than 100 years it has been the cause of more deaths in Americans surpassing any other major reason. Cardiovascular disease continues to be the number-one cause of death in the US,   averaging one death every 37 seconds (AHA, 2008a). The American Heart Association estimates that 80.7 million Americans have one or more cardiovascular disorders including: dyslipidemia, coronary artery disease (CAD), Congestive Heart Failure, hypertension, stroke, and peripheral vascular disease.  People participating in moderate amount of physical activity have a 20% lower risk for CAD, while those undertaking higher amounts have a 30% reduction of risk. When talking about these heart conditions and exercise always get clearance from your doctor before starting any kind of exercise.  

Whether trying to prevent, or trying to recover from a myocardial infarction, cardiac surgery, or other cardiac procedures (e.g., angioplasty, stenting) anyone can benefit from an appropriately designed and monitored exercise program.  Once cleared by a doctor for exercise, a functional capacity test or a graded exercise test should be used to establish a safe exercise level. Then heart rate limits, exercise limitations, and other program recommendations can be made so a personal trainer has the parameters to work within.  When incorporating a routine after a heart related surgery or trauma it is advised to work with breathing. Learning to use the diaphragm to breath will have many benefits and can help the body heal quicker. Conversely, using the Valsalva technique, holding the breath through the sticking point of an exercise is not recommended for several reasons. It creates a lot of pressure around the abdominal area and can create a lot of stiffness there.  Also, it can raise blood pressure. The Valsalva technique has been known to cause headaches, hemorrhoids, and even aneurisms. In fact isometric exercises should be avoided altogether. That means that holding a plank or a squat or any type of exercise where your exerting effort to hold a position should be avoided post heart surgery until there is clearance from the doctor. Hopefully within that timespan the client has mastered breathing techniques which can help when transitioning into any isometric exercises.

For most clients, the initial mode should consist of low-intensity endurance exercises such as low-impact aerobics,  walking, swimming, stationary cycling, or other ergometer use. The goal is to gradually increase to moderate-intensity exercise utilizing interval-type training. A general recommendation is 3-5 days a week of aerobic training and 2 days per week of resistance training.  The resistance training is where the danger lies because it requires having a knowledge of biomechanics to do exercises safely. This is where a good fitness professional can be of great help.  

Basically any type of activity which involves a large amount of muscle performed in a rhythmic fashion and sustained for more than a few minutes can be classified as cardiorespiratory exercise.  If this type of exercise is done regularly, the heart adapts and becomes stronger. Walking, running, cycling, rowing, and skating are considered to be the primary cardiorespiratory exercises. Many other movements can be considered cardiorespiratory exercise including stairs, elliptical, arm bike, game play activities, and even dancing. Cardiorespiratory recommendations for healthy adults can be done on average in 3 days or can be spread out differently to 5 days.  If you exercise at a moderate intensity and are doing an aerobic exercise like walking it is recommended you do it at least 5 days a week. If exercising at a vigorous intensity it is recommended to exercise at least 3 days a week. Those are minimums so it is important to know what level of endurance you need to meet your fitness goals. If your goal is to run a 50k road race you will have to intensify your training. I always recommend using different modes of cardiorespiratory training to avoid an injury due to the overuse of a repetitive action. However, it does benefit a competitive runner to run most days because that is their primary

action to master.  

A very important number to know is your maximum heart rate. 

There are two methods to determining your Maximum Heart Rate (MHR).) The first method is a graded exercise test using an EKG monitoring device. This process is the most accurate method of determining this important number.  

The test is typically performed to maximal exertion. This means the client has completed the test when they no longer can tolerate the activity, have achieved a predetermined number, or  signs or symptoms arise which would warrant the test termination. The other method of determining MHR is by using a simple prediction equation introduced in 1971. “220 – Age” is a widely known equation used but there are several issues with this formula.  One major observations is, there is a standard deviation of 10-20 beats per minute or more. This means that if you’re 20 years old your maximum heart rate could be anywhere between 180-220 beats per minute. An interesting fact is that the maximum heart rate generally cannot be influenced by training. Resting heart rate can be influenced by training. Typically the lower that number is the lower your heart rate would be during training as compared to someone with the same maximum heart rate.  

High blood pressure, high blood cholesterol, and smoking are key risk factors for heart disease. About half of Americans (47%) have at least one of these three risk factors. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including; diabetes, overweight and obesity, unhealthy diet, physical inactivity, and excessive alcohol use(cdc.gov). The Center for Disease Control and Prevention has some good basic information for anyone seeking to begin a healthy lifestyle. The website also lists references for additional information.  If you are looking to get help with exercise, nutrition, mental health or looking for way to manage stress physically or emotionally please come to Ampersand Integrative Wellness and we can help you at whatever scenario you are at with your fitness journey.  

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