Heart Health

Your heart health is key to preventing heart disease. Making fitness a part of your life can have a tremendous effect on your heart health, and it's estimated that just 22% of Americans engage in enough activity for health maintenance purposes. Adding to that is the statistic that up to 12% of all deaths can be attributed to inactivity. When a person is physically inactive, the risk of heart disease increases by about 1.5 to 2.4 times — it is a major independent coronary risk factor. Exercise not only reduces the risk of heart disease, it improves survival from a heart attack. Other benefits of exercise include improved immune function, improved stability of heart rhythms, better muscle tone and posture and increased stamina and energy.

The importance of your heart health can't be stressed enough, as it's the key to preventing heart disease. One of the best ways to prevent heart disease is to exercise, as it can have a tremendous effect on your heart health.

Just 22% of Americans are estimated to engage in enough activity for health maintenance purposes, and 12% of all deaths can be attributed to inactivity. Adding to that, the risk of heart disease increases by about 1.5 to 2.4 times when a person is physically inactive.

Exercise is greatly beneficial when it comes to heart health. A person who exercises may have improved immune function, better muscle tone and posture, increased stamina and energy, and improved stability of heart rhythms. Exercising also improves survival from a heart attack.

So what kind of exercise activities yield heart healthy benefits? Benefits to heart health come mostly from aerobic activities, which are most effective in terms of burning calories. Aerobic activities are continuous in nature, rely primarily on the legs and other large muscles of the body, and are conducted at a moderate to brisk pace that is sustainable. Some aerobic activities that benefit heart health are: walking, swimming, rowing, cycling, and step classes. And as long as the intensity doesn't leave you breathless, running and stair climbing can also be considered aerobic activities.

Exercise

The target heart rate has become widely used as an index of exercise intensity. When exercising, it's important to pay attention to the prescribed target heart rate range. The intensity should be above a minimal level required to produce a training effect but below a load that would cause abnormal signs and symptoms. The target heart rate range allows a person to see if their heart rate is adapting to the exercise at a given workload.

Target Heart Rate: The Karvonen Method

Individuals who are not on any medications that may alter their heart rate or have not had a cardiac event 6-8 weeks prior can calculate their target heart rate range through what is known as the Karvonen Method. The Karvonen Method of finding your target heart rate takes into account your age. This is because our maximum heart rate drops as we get older. We recommend that you use 40-75% of your predicted maximum heart rate reserve (HRR).

A simple way to calculate this is:

Predicted Max heart rate (MHR) = 220 - age_______
Heart rate reserve (HRR)= MHR - resting heart rate (RHR)______
Target heart rate=
(HRR x .40) + RHR_________
(HRR x .75 + RHR)_________

Theses two numbers give you the range at which you should be exercising. This is the Karvonen Method of finding your target heart rate.

Target Heart Rate Guidelines for Those on Medication

A prescribed target heart rate for those individuals on medication is different because of the fact that certain medication can alter the heart rate. If you are unfamiliar with your medication statues on your heart, please ask your doctor.

Another important factor for cardiac individuals is the rated perceived exertion (RPE) scale. The RPE scale has been proven to be a valuable aid in prescribing exercise in cases where the heart rate response to exercise is altered due to the medication. An average RPE is between 3 and 4 (moderate to somewhat hard).

Remember: You should be able to talk during your exercise without being out of breath.

Always look at your target heart rate range to be sure that you are working at the intensity you need to be. If you are not given a target heart rate range, please see one of the staff members to be prescribed one.

Contributed by: Pat Dunn, MS/MBA - Hearts & Minds

Aerobic Fitness

Activities that yield heart healthy benefits come mostly from aerobic fitness. In addition to providing the most heart health benefits, aerobic fitness is the most effective for burning calories.

Aerobic: The muscle energy used to produce an activity comes from burning oxygen and fuel stored in the body

Aerobic Fitness Activities

Rely primarily on the legs and other large muscles of the body
Are continuous in nature and without a start/stop component such as baseball or football
Are conducted at a pace that is moderate to brisk and sustainable

Activities such as walking, cycling, swimming, aquasice, rowing, step classes and aerobic classes are aerobic. Running and stair climbing can also be considered aerobic as long as the intensity does not leave you breathless.

Aerobic Fitness: Safe Training

Whether your goals are to increase you activity level for better health or to work towards a better level of physical fitness, safe guidelines are essential. The following recommendations apply in principle to everyone, although a more structured approach is beneficial for those seeking to optimize their fitness.

Within each exercise session there are three (3) important phases:

WARM-UP: 5+ minutes - begin with the activity at a slow easy pace (To safely prepare your heart and body for more vigorous activity)
TARGET: 15-30 minutes - continuous aerobic activity at you training intensity
COOL-DOWN: 5+ minutes - taper off to slow easy pace
(To safely return your heart and body to a recovery state)

Keeping these three phases in mind, if a person had only 15 minutes to devote to exercise they would begin at an easy pace for 5 minutes, gradually build up to walking briskly for 5 more minutes, and would then gradually taper down to an easy pace for the last 5 minutes.

It has been said that during activity it takes 10-15 minutes for a person's fat burning system to "kick in". Therefore by extending our warm up we become a little better at using any fat stores we are trying to burn during our target session.

Aerobic Fitness: Intensity

Each exercise session is a blend of time and intensity. The goal here is to determine that maximum training intensity a person can work up to and maintain. This often includes balancing the potential for m maximum benefit with maximum safety and reduced chance of injury.

Target heart rate: In designing your target heart rate a variety of factors have been examined. In addition to you Exercise Stress Test results, your goals, fitness history, current health, occupation, and leisure pursuits have all been considered. Do not compare your target heart rate to others. A higher or lower target does not mean one person is healthier or more fit than another. Try to remember you target heart rate and keep it mind when exercising. Think of it as a speed limit that will help you reach your goals of better health.

It is common for target heart rates to be 50-85% of a person's maximum exercise capacity. For most folks the lower half of these ranges usually works best.
There are two ways to determine your heart rate during exercise
1) Pulse checks
2) Heart rate monitors

Checking your pulse usually requires slowing down or stopping exercise for an accurate count. In order to keep from getting dizzy always keep some movement going - i.e. shift your weight from one leg to the other.

Turn your palm upwards and cock the wrist back (towards the floor) on your non-watch hand
Place the flat of the index finger and middle fingers of the other hand on the "thumb side" of your wrist
Feel for you (radial) pulse
Counts the beats you feel for ten seconds
Multiply by 6 in order to get beats per minute (BPM)

Heart rate monitors have the advantage of instant feedback as to heartrates during exercise.

In general there are two basic types:

ECG type-consists of leads placed on the patient's chest
Pulse type- finger/ear clip

Listen to your body when you are exercising. It is important to pay attention to how the exercise feels. That Rating of Perceived Exertion (RPE) scale is a useful way of expressing this.

Frequency: In general, 3 - 5 training sessions are usually recommended per week. For best results try to spread the activity our during the week. As mentioned before, it is wise to partake in a variety of activities so as not to over-stress and individual part of the body.

Aerobic Fitness: Exercise Precautions

Remember to always warm-up and cool-down
Do not push yourself over you target heart rate
Avoid brisk activity after a meal. A wait of about 2 hours is usually wise
Fuel in needed for exercise. If you haven't eaten for several hours have a light snack before exercising
Avoid exercise during illness or infection
Smoking, alcohol, or caffeine doesn't mix with exercise. Avoid these for two hours before and after exercise
Caution is required for extreme temperatures

Aerobic Fitness in Hot Weather

Aerobic fitness in hot weather requires loose clothing that is light in weight and color. Cotton is best.

Remember to drink cool water before, during, and after exercise. This will help replace fluid lost through sweating. Don't wait until you feel thirsty. Depending on conditions, you should drink one cup of fluid for about every 20 minutes of activity. Beware of sport drinks! Unless they are well diluted (less than 1/2 of recommended concentration) they may cause stomach upset.
Because high heat and humidity will increase the workload on your heart - slow your pace and reduce your exercise duration.
Your heart rate is an excellent sign of the combined effect of heat and exercise workload on your heart. Don't push yourself beyond your target heart rate.
A longer warm-up and cool-down phase is beneficial
Try and pick a cool time of day or a cool location for exercise
If exercising indoors a fan can aid with heat loss
*People with heart problems may need to be especially careful to reduce the heat load on their bodies.

For these reason saunas, hot tubs and in some cases overly hot showers are not recommended.

Aerobic Fitness in Cold Weather

Requires dressing inlayers
If you will be perspiring during exercise, try to avoid cotton clothing next to your skin. It becomes wet and cold. Synthetics, silks, and woolen materials are much better under these situations
Wearing a hat and mitts will helps to conserve body heat
A wind-resistant outer shell that lets perspiration evaporate will reduce chilling
An extended warm-up and cool-down are important during cold temperatures
Remember to take wind chill into account
Wearing a scarf over your mouth and nose may help if cold airs makes you uncomfortable

Aerobic Fitness: Flexibility

A certain degree of flexibility is important if you are to achieve optimal wellness. Flexibility decreases as a result of age and inactivity. Not only does this impact recreational performance, but in some cases has been known to result in structural imbalances leading to low-back pain and serious injury.

Aerobic Fitness: Tips for Stretching

Stretch only those muscles that have been warmed up with activity
A good time to stretch is after the warm-up and especially after your cool-down
Breathe naturally and try to relax - don't hold your breath
Stretch only to a point of mild tension - there should be no pain
Hold the stretch for 10 - 30 seconds
Do not bounce
Pay close attention to doing each stretch properly, because incorrect technique can lead to injury. If you have any questions please ask your exercise specialist.

Contributed by: Pat Dunn, MS/MBA - Hearts & Minds

Common Exercise Myths

The following are common exercise myths.

No pain, no gain (pain is an indication of injury which can slow your progress
More is always better (too much in the way of intensity or volume can lead to injury)
Sweating is an indication that you're working at the right intensity (the fact you're sweating during exercise is more a function of the environmental temperature and clothing worn rather than an indicator of intensity.
Shortness of breath is an indication that you're getting the maximum benefit from your exercise (Breathlessness to the extent that you would not be able to talk is a sign that you're working beyond your limits).
Sweating helps to lose weight (this is only temporary as the weight lost is mostly water. Excessive sweating without replenishment of fluids lost can be dangerous - especially under warm conditions
A strict training program is required for health benefits (as mentioned before, new research indicates that an accumulation of 30 minutes of moderate activity during the day is sufficient for health purposes)
Older people of those with hear disease should not exert themselves (although overexertion is not recommended for any age group - everyone needs and can benefit from appropriate physical activity
Doing sit-ups is the best way to lose fat around the middle (you cannot spot reduce fatty areas!). Although abdominal exercises are important for helping to stabilize the spine they do not burn significant amounts of calories by themselves to reduce excess fat - aerobic exercise is the best way to do this.

Contributed by: Pat Dunn, MS/MBA - Hearts & Minds

Tips for Staying Active

Pick activities you enjoy
Varying your activities will help to reduce injury and keep your program more interesting
Keep the intensity at a comfortable level
Exercise with a friend, co-worker or family member
Set aside times for exercise each week
Set attainable goals
Expect to back-slide every now and then - this happens to us all
Follow the exercise precautions in the previous section

Contributed by: Pat Dunn, MS/MBA - Hearts & Minds

Target Heart Rate

Target Heart Rate: The Karvonen Method

A simple way to calculate this is:

Predicted Max heart rate (MHR) = 220 - age_______
Heart rate reserve (HRR)= MHR - resting heart rate (RHR)______
Target heart rate=
(HRR x .40) + RHR_________
(HRR x .75 + RHR)_________

These two numbers give you the range at which you should be exercising. This is the Karvonen Method of finding your target heart rate.

Target Heart Rate Guidelines for Those on Medication

Remember: You should be able to talk during your exercise without being out of breath.

Contributed by: Pat Dunn, MS/MBA - Hearts & Minds

Controlling Your Cholesterol

Cholesterol is a waxy fat that is present in human beings. Approximately 80% of it is manufactured by the liver; the remainder if it comes from animal products that we eat such as meat, eggs and dairy products. LDL cholesterol (low-density lipoprotein) is the major contributor to plaque build up in arteries. HDL cholesterol (high-density lipoprotein) is the "healthy" cholesterol that carries the "lousy" cholesterol (LDL) away from the arteries. Triglycerides are a fatty material that may be stored as fat or may travel through the blood. High levels of triglycerides in the blood increase the risk for plaque build up in the arteries.

Components of a heart healthy, low cholesterol, low fat diet consist of:

Eating fewer high fat foods, such as fried foods, cheese, butter, shortening, palm oils, coconut and red meat
Keep total fat intake to less than 30% of your calories in a week and saturated fat to less than 10 – 20 GMS /day.
Lower cholesterol intake to less than 200 mg/day if you have a history of heart disease or diabetes and less than 300 mg/day for everyone else
Read food labels! Pay attention to serving size and the associated amount of fat, saturated fat, cholesterol, and sodium in the product serving size. Remember that most processed foods ("convenience" foods) are very high in fats and salt.
Limit serving sizes. A serving of meat is 3 ounces, about the size of a deck of playing cards.
Eat 5 combined servings of fruits and vegetables per day (1/2 cup is a serving). Fresh and frozen varieties are preferable. Canned vegetables are high in salt, and canned fruit is high in sugar.
Eat fish 2 – 3 times per week. The Omega-3 fatty acids found in "deep water" fish (those found in the ocean) reduce triglycerides and LDL cholesterol, which reduce cardiac events.
Reduce your intake of sugars and sweets. If you drink alcohol, do so in moderation. This is especially important if your triglycerides are high.
Choose canola or olive oil.
A high-fiber diet can reduce the amount of cholesterol in the blood. High fiber foods include fresh fruit and vegetables and whole grain foods.
If you are overweight, lose excess weight slowly, no more than two pounds per week. Losing weight will not only help control your lipids, it will also improve blood pressure readings.

Contributed by: Phyllis Cox, RN - Lipid Nurse, Austin Heart

Quit Smoking

Cigarettes contain nicotine which produces adrenaline, causing your heart to beat faster and work harder.
Cigarettes can cause your blood pressure to become higher, also making your heart work harder.
A smoker's blood may contain up to 15 percent less oxygen causing the heart to work harder to get enough oxygen to the rest of your body.

Stress Management

Managing stress makes sense for your overall health. But current data doesn't yet support specific recommendations about stress reduction as a proven therapy for cardiovascular disease.

"Stress" response describes the condition caused by a person's reaction to physical, chemical, emotional, or environmental factors. Stress can refer to physical effort and mental tension. It's hard to define a high level of emotional or psychological stress to measure in a precise way. All people feel stress, but they feel it in different amounts and react to it in different ways.

More and more evidence suggests a relationship between the risk of cardiovascular disease and environmental and psychosocial factors. These factors include job strain, social isolation and personality traits. But more research is needed on how stress contributes to heart disease risk. We don't know if stress acts as an "independent" risk factor for cardiovascular disease. Acute and chronic stress may affect other risk factors and behaviors, such as high blood pressure and cholesterol levels, smoking, physical activity and overeating.

More research is also needed on stress's role in heart disease risk among women and minorities. Also, only a few studies have examined how well treatment or therapy works to reduce the effects of stress on cardiovascular disease. Studies using psychosocial therapies to prevent second heart attacks are promising. After a heart attack or stroke, people who feel depressed, anxious, or overwhelmed by stress should talk to their doctor or other healthcare professional. These feelings are relatively common and help is available.

Contributed by: American Heart Association, www.americanheart.org

Interesting Heart Facts

The human heart is one of the most important parts of the body. It is responsible for moving blood and other nutrients throughout the entire body.

The heart is constantly beating and does not stop. The heart beats approximately 100,000 times a day and about 35 million times a year!
The body has about six quarts (5.6 L) of blood in it that the heart circulates through the body about three times every minute.
The heart is located in the center of the chest between the lungs.
An adult heart is about the size of two fists put together, a child's heart is about the size of one fist.
The main function of a heart is to pump blood through the body.
The heart has four main chambers: the right atrium, right ventricle, left atrium, and left ventricle.
In 1893, the first successful heart surgery was performed by a doctor named Dr. Daniel Hale Williams.
In 1967, the first heart transplant was performed from one person to another.
A stethoscope is an instrument that a doctor uses to listen to your heart to make sure it is working right.
Too much salt each day can make your heart work harder than it needs to since it causes fluids to be retained in your body.

Contributed by: Learning Resources, Cross Section Heart Model

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