Why heart dis­ease pa­tients need to ex­er­cise

New Straits Times - - Heal -

For sta­ble CVD pa­tients, ex­er­cise should start with low in­ten­sity such as walk­ing. WHAT ARE THE BEN­E­FITS OF EX­ER­CISE FOR PA­TIENTS WITH CAR­DIO­VAS­CU­LAR DIS­EASE (CVD)? 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 ac­tive 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

For ad­vanced CVD pa­tients, ex­er­cise is of­ten done un­der su­per­vi­sion. mod­er­ate in­ten­sity (e.g. walk­ing, brisk walk­ing, cy­cling less than 20kmph).

A pa­tient with ad­vanced dis­ease is en­cour­aged to ex­er­cise as well but at a 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 Pa­tients with CVD who are phys­i­cally ac­tive have a 31 per cent lower risk of death. 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 a 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.

If you have ad­vanced CVD, you need to dis­cuss with your 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.

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