Exercise After A Heart Attack?

Absolutely! Working out can be best way to get your heart healthy again

Had a heart attack? Undergone cardiac surgery? Been given a diagnosis of atherosclerosis? Don’t let it paralyze you: Get moving! Quite simply, exercise helps heart patients live longer. In a review of 48 studies, published in the American Journal of Medicine, researchers found that patients whose cardiac care programs included exercise had lower death rates than patients whose programs did not. And not just by a little — such programs can reduce the risk of heart-disease-related death by 30 percent, says Gordon Blackburn, PhD, program director of cardiac rehabilitation in preventive cardiology at the Cleveland Clinic.

That’s not to say you should run a marathon tomorrow or even jog around the block. You need to undertake your exercise program with the guidance of a physician. But don’t wait for your doctor to nudge you to exercise — you may have to take the lead.

Enlist Your Doctor’s Support
Amazingly, only 15 percent of heart patients nationwide who qualify for cardiac rehabilitation programs participate in them, even when they’re covered by insurance. In a survey, the majority of patients who didn’t join a program attributed it to a lack of strong physician support, Dr. Blackburn reports.

Cardiac rehab programs typically require a physician referral. But don’t wait for your doctor to hand you one or even to suggest that you try a program — ask your doctor how cardiac rehab fits in with your care.

Find Your Capacity
Before a program is designed, your doctor will probably have you take an exercise test to determine how much exertion is safe for you. Also called an exercise stress test, it uses an electrocardiogram machine (EKG) to monitor your heartbeat while you’re on a treadmill or stationary bike. This helps your doctor determine what’s called your functional capacity — essentially, how much activity your heart will allow you to do.

With that information, your doctor or rehab team can build a program to improve your capacity. “When we see a functional level that’s very low, there’s an increased risk over the next five years” of heart attack, stroke or other cardiovascular problems, Dr. Blackburn says. When functional capacity improves, there’s a decrease in that risk.

Move the Needle
Cardiac rehab programs are built around cardio fitness activities, such as walking on treadmills and pedaling stationary bikes (although other activities may be included, depending on your abilities). The goal: to get you to be able to do more. And to keep doing it!

That “more” is measured in units of intensity called METs (metabolic equivalents), which rate how much energy an activity requires, compared with how much energy is used when you’re lying still. For instance, a leisurely 2-mile-an-hour stroll has a MET of 2; using a stationary bike at 50 watts with very light effort is ranked at 3. Increasing your functional capacity by one MET — that is, moving up from strolling to easy pedaling — reduces your risk of heart attack or stroke by 9 to 12 percent. As you increase intensity (by, say, picking up the pace of your walk), your risk continues to drop.

Enjoy Life Again
Not only will your cardiovascular system begin functioning better, you’ll enjoy a greater quality of life. A 2003 study of women who underwent cardiac rehab found that along with increased exercise capabilities, participants reported feeling better physically and mentally, eating better and worrying less. Other studies have found that along with improving body weight, HDL levels and other risk factors, cardiac rehab decreases anxiety and depression.

Live longer, stronger and happier? That’s a prescription most of us can live with.

Try This! Schedule an appointment with your cardiologist to discuss exercise rehabilitation options.

Related Links:
Learn how managing stress can help fight heart disease
The best foods for a healthy heart
Want to learn how to eat right, for good? Try GO! Foods for You, a new online program from Cleveland Clinic.

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