Part of the secondary prevention of heart disease is exercise so it’s best that patients work out.
WHAT ARE THE BENEFITS OF EXERCISE FOR PATIENTS WITH CARDIOVASCULAR DISEASE?
Cardiovascular disease includes diseases of the heart and blood vessels.
Examples are coronary heart disease, heart failure, stroke and peripheral vascular disease.
Physical activity in CVD patients is part of the secondary prevention of heart disease.
Patients with CVD who are physically actively have a 31 per cent lower risk of death.
The benefits of physical activity in CVD patients includes reducing recurrent symptoms, enhancing quality of life, increasing muscle fitness, increasing functional capacity and, most importantly, reducing the likelihood of death.
At the same time, physical activity will improve other risk factors of heart disease such as hypertension, diabetes, high cholesterol and obesity.
It is also important for CVD patients to control other risk factors to increase the benefits of exercise.
These include stopping smoking, controlling diet, and having optimum treatment for hypertension, diabetes and high cholesterol.
IS IT SAFE FOR A PERSON WITH CVD TO EXERCISE?
The benefits of physical activities far outweigh the risks.
The risk of a major heart event occurring in a patient attending supervised cardiac rehabilitation programme is 1 in 117,000 hours of participation.
Fatal event occurs 1 in 750,000 hours of participation. Recurrent symptoms are most likely to occur in patients who are least physically active.
Any patient with a stable and well-compensated condition is encouraged to exercise up to moderate intensity level (e.g. walking, brisk walking, cycling less than 20kmph).
A patient with advanced disease is encouraged to exercise as well but at different intensity and setting. Please discuss with your cardiologist before you start exercising.
Your doctor will assess your heart condition. He may look into any condition where exercise is contraindicated.
In some situations, some tests, such as exercise stress test is warranted, especially for patients who are unsure about safety and who want to do vigorous intensity exercises (jogging, running, cycling more than 20kmph and swimming)
WHAT ARE THE RECOMMENDED EXERCISES FOR A PERSON WITH CVD?
If your condition is stable, you should aim for 150min/week of exercise, at moderate intensity, gradually, over time.
Usually, it may take six to eight weeks before you can do 150min/week exercise.
You should start with low intensity such as walking slowly. Start with 5-10 minutes, twice a day, a few days per week as tolerated.
Increase the frequency, duration and later intensity (from low to moderate intensity exercise).
You may include resistance exercises too. But you may need a trained staff to help you in resistance training.
If you want to increase to vigorous intensity level (e.g. cycling more than 20kmph, jogging/running), it is recommended you do an exercise stress test first.
Those with advanced CVD need to discuss with their doctor before starting exercise.
For this group, the exercise is usually less intense, of shorter duration, less frequent and with more rest periods.
Progression is usually very slow with lower target. In many situations, exercise is done under supervision.
An avid sportsman who believes in the healing powers of exercise, Assoc Prof Dr Ahmad Taufik Jamil is Universiti Teknologi Mara’s public health consultant and exercise physician. Reach him at firstname.lastname@example.org.