We hear it all the time to eat right and exercise, that it’s good for us, especially for our hearts, but do you really know how or why it’s beneficial?
Heart disease is the number one killer of men and women in the developed world. The most common causes are inactivity and poor eating habits that result in atherosclerosis, a narrowing of the arteries that can restrict blood flow.
“There are modifiable and non-modifiable risk factors,” explains Rosa Godoy, Exercise Physiologist for Lee Memorial Health System’s cardiac rehabilitation program. “Modifiable risk factors are things like your diet, exercise, smoking and healthy weight maintenance. Non-modifiable risk factors are things like genetics, family history and age. You have to look at the non-modifiable factors in combination with the lifestyle they’ve been living for years, even decades.”
Through the discovery of the risk factors for heart disease, the research has also revealed ways to prevent and treat it. Experiencing a cardiac event or receiving the diagnosis of a heart condition can be frightening, but cardiac rehabilitation offers patients the opportunity to take control, learn and manage their health.
The AHA and the American College of Cardiology (ACC) give a referral to cardiac rehabilitation the same level of recommendation as treatment with aspirin, statins or beta blockers; meaning it is integral to prevention as well as recovery from heart attacks.
Cardiac rehabilitation programs are used to improve the health of patients who are recovering from a heart attack or recent heart surgery. Seeing the value in cardiac rehab, the Centers for Medicare and Medicaid Services (CMS) expanded coverage for cardiac rehabilitation to patients with chronic, stable heart failure, like seventy-seven year old Curtis Johnson of Fort Myers.
Johnson is currently in his second round of cardiac rehab. About 16 years ago his heart function dropped dramatically from a rate of 65 to 70 percent to about 10 to 15 percent. “There’s no surgery, no heart attack, no pain,” Johnson said. “It’s just that my heart was not functioning fully and became enlarged from trying to compensate.” Johnson may have a weakened heart, but refuses to let it slow him down.
Approximately one-third of chronic heart failure patients will improve with medication while the remainder will either stay the same or get progressively worse. “After trying the medication for a while I still found it difficult to walk from one room to another,” Johnson said. “I thought there must be something better than this.”
After performing a stress test, Johnson was cleared to sign up for cardiac rehab with limitations to protect his weakening heart.
“My heart rate could not get too high so they were very careful with me. I spent three months in cardiac rehab and got my heart function back up to 45 percent,” he says. “Using what I learned I was able to maintain that level for 16 years, but my heart has gradually drifted off to 15 percent again. My heart function slowly went down this time. It wasn’t sudden like the first time.”
There are five major components of physical fitness: cardiovascular endurance, muscle strength, muscle endurance, flexibility, and body composition. Each is important for different reasons, but cardiovascular endurance and body composition are the most relevant when it comes to heart health.
“Cardiovascular endurance refers to how well your heart and lungs function together to supply your body with the appropriate amount of oxygen,” explains Anita Arnold, D.O., cardiologist with Lee Physician Group. “Any aerobic activity that raises your heart rate, like running or biking, can help improve cardiovascular function.”
Body Composition evaluates the makeup of your physique. It determines the amount of fat you carry in addition to muscle, bone and organ tissues. According to the American Heart Association (AHA), obesity levels continue to increase: 69% of all adults are now obese or overweight. A good indicator is the size of your waistline. A waist circumference of 40 inches or higher in men, and 35 inches or higher in women, puts you at higher risk for cardiovascular events.
“The larger the abdominal girth the higher risk for health problems. The correlation is that the visceral fat around the organs creates a lot more work for the heart,” says Godoy.
“Research suggests that a healthy diet and regular exercise together are more successful than dieting alone; and, not only do they deter modifiable risks like your weight, but also help to lower blood pressure and cholesterol levels which can be hereditary,” says Dr. Arnold.
The AHA suggests the following:
To improve overall cardiovascular health: at least 30 minutes of moderate-intensity aerobic activity at least five days per week for a total of 150; or at least 25 minutes of vigorous aerobic activity at least three days per week for a total of 75 minutes; or a combination of moderate and vigorous-intensity aerobic activity. Add moderate to high-intensity strength training at least two days per week for additional health benefits.
To lower blood pressure and cholesterol: an average 40 minutes of moderate to vigorous-intensity aerobic activity three or four times per week.
Beginners or individuals with physical limitations: you can also experience benefits by dividing it into two or three segments of 10 to 15 minutes per day, five days per week.
Experiencing or recovering from cardiac issues: Though it may seem frightening or overwhelming to begin exercising at this time, it’s actually a valuable part of recovery after a cardiac event or the diagnosis of a heart condition. It’s important to talk to your doctor to determine what is safe and best for you.
In addition to exercise, cardiac rehabilitation programs include risk factor education, lifestyle modification classes and support. It helps patients improve their quality of life, experience fewer hospital stays and reduce the risk of developing future problems.
There are three phases of cardiac rehab. Phase I is education and activity for heart attack patients while still in the hospital. Johnson is two months into Phase II which focuses on improving quality of life and reducing the risk associated with heart problems through monitored exercise with a strong emphasis on education and social support.
“I’ve been increasing my activities slowly and I almost never get short of breath now,” Johnson said. “I can feel that my heart function has gone back up but I won’t have any tests completed until I finish the three month program.”
Upon completion, Johnson has the option to join Phase III which is considered a maintenance program for patients who need less supervision and monitoring. It emphasizes independence while helping patients maintain a heart-healthy lifestyle.