Coronary Heart Disease and Exercise

Simon Hunt BSc (Hons)

Exercise Physiologist

www.Sihunt.co.uk

Coronary Heart Disease

Complex Disease Initiated by injury/damage to inner

lining of the coronary arteries Build up of atherosclerotic (fatty)

plaque causing blockage Plaque consists of fat deposits. Made worse by smoking, high

cholesterol, inactivity, diabetes, hypertension and genetic factors

Physical Activity or Exercise?

Physical Activity (PA)Washing the carCleaning windowsWalking the dog

ExercisePlannedOrganised Controlled

The Circulation

Why Exercise or Increase Activity?

To Improve CirculationO² & NutritionRemove Waste

Products

The Heart and Circulation

Cardio Vascular Exercise Benefits:

More heart strength and circulation reduces risk factors

Body circulation also improves with Resistance and Interval training

Risk Factor Reduction through exercise

Blood Pressure LDL (bad cholesterol) HDL (good cholesterol) Insulin Sensitivity Glucose (sugar) Metabolism Body Fat Anxiety and Depression

Long term Exercise Adaptations

Increased Maximal Oxygen Uptake (VO²) At any given level of Sub Max Exercise:

Reduced Heart Rate & Systolic Blood Pressure• Therefore reduced work load on the heart.

Reduced risk of arrhythmias due to reduced catecholamine (adrenaline)

Up to 20% Improvement in Physical Capacity seen in Heart Failure patients!

Why do we have a heart? Too move blood around the body, working

against gravity Other mechanisms that aid return of blood

to heart are: Inhalation – suction Valves in veins Muscles that surround the veins.

Therefore Keep breathing Keep moving your feet

Exercise Recommendations for a Healthy Heart

30 minutes of Cardio Vascular Exercise

3 – 5 Times a Week 70 - 80% max Heart Rate

Frequency, Intensity, Time (F.I.T) Exercise Model

o Frequency - 3 - 5 times per week

o Intensity - 70 - 80% max heart rate

o Time - 30 mins at intensity

Types of Exercise

Cardio Vascular –Large muscles, rhythmic + continuous, using O². Getting a little breathless e.g. walking briskly, swimming, jogging

Interval Training (exercise - rest - exercise)

Resistance Work – Light Weights – 1 set of 15 Reps – increase metabolic tissue mass

Your Exercise Program

15 Minutes Warming Up inc. stretching

30 Minutes of Cardio Vascular exercise (achieve through interval training if necessary)

5 – 10 Minutes of Resistance (can be used in intervals to start with)

10 Minutes Cool Down

Individual Exercise Programs

Will Vary Depending on:Previous Fitness LevelsType of Cardiac IncidentArea of the heart affectedMedicationsOther problems: – arthritis, old

injuries etc

General Rules

Allow an hour after a meal Have a drink of water handy 1 litre Avoid extremes of temperature

18-22oC and dress accordingly Feel a little breathless – Not

speechless! Gradually Increases (Frequency.

Intensity. Time)

Do’s and Don’ts

Don’t Exercise if you are feeling unwell. Do have GTN spray/tablets with you Do pace yourself. Do heed warning signs too STOP:

PainBreathlessnessDizziness etc

Medication & Exercise Medication and Exercise work well

together. Never stop taking a medication because you are going to Exercise

Beta Blockers & ACE Inhibitors. ACE Inhibitors aid exercise capacity in the long-term.

Check with your GP before commencing a new exercise or physical activity regime.

Avoid Contraindicated Exercises

Static non-moving Exercise Heavy weights Arms above the Head for any length

of time Standing still Holding your breath Becoming thirsty

Summary

Decide on your level of physical activity capacity

Warm up and cool down

Progress gradually (F.I.T) Aim for 30 mins. Cardio Vascular 3 – 5 times a

week Be alert to symptoms - listen too your body

Balance Medication and eating times with

exercise.

Chose an activity you enjoy with friends

Avoid contraindicated exercise