Features May 2016 Issue

Exercise Helps Lessen the Blow of a Heart Attack

Studies show that people who are physically active have greater odds of surviving a heart attack and of avoiding depression after the event.

One of the goals of regular exercise is, of course, to avoid a heart attack. But if that event, known clinically as a myocardial infarction (MI), is in your future, just know that being physically active in the months and years leading up to a heart attack can help you survive it both physically and emotionally.

Two reccent studies have underscored the importance of fitness in lowering your odds of dying of a heart attack and of developing depression following an MI. In one study, based on the Henry Ford Exercise Testing (FIT) Project, researchers found that heart attack victims who had greater fitness levels were significantly more likely to survive the events and have more successful recoveries. The other study, published in the American Journal of Medicine, found that individuals who exercised regularly before having a heart attack were much less likely to to be diagnosed with depression compared with heart attack patients who seldom, if ever, exercised.

“People who exercise regularly and have a greater fitness level tend to have overall less co-morbidities such as diabetes, obesity and smoking, just to name a few,” says Michael Crawford, manager of the Cardiac Rehabilitation Program at Cleveland Clinic. “Also, if the heart and the rest of the body are in better physical shape, a person can tolerate more physical stress and trauma.”

Do Your Thing

The American Heart Association recommends getting at least 150 minutes of moderate-intensity exercise every week. While a workout of 30 to 40 minutes every day (or most days) is great, breaking your exercise up into smaller 10-minute chunks is okay too if you have limits on your endurance or exercise capacity.

If you have risk factors for a heart attack, such as high cholesterol, high blood pressure, obesity, smoking or a family history of heart disease, regular exercise is vital, but should be done wisely.

“Any exercise program should be tailored to each individual based on their goals and health status,” Crawford says. “Many health conditions, such as diabetes, obesity, heart disease, cancer, orthopedic issues, syncope (fainting due to a drop in blood pressure) or multiple sclerosis, as examples, can alter ‘traditional’ recommendations. If someone has heart attack risk factors, they should discuss with their physician if they have any exercise restrictions, or possibly have an exercise test done to ensure there are no significant underlying heart problems.”

Take Precautions

Getting fit through regular exercise may help prevent a heart attack. If not, it may help you survive one more easily.

Exercise can cause stress on the joints, heart, muscles, vascular system and endocrine system, Crawford explains. “Some precautions to take may include starting with lower intensity or duration, then building up over time to allow these systems to adapt to the physical stress,” he says.

Various conditions can affect can affect your ability to exercise. But exercise can also exacerbate or otherwise impact your particular health issues. For example, blood pressure increases during exercise, and if uncontrolled it could cause harm. Some diabetics use insulin or insulin-stimulating oral medications that can cause low blood sugar with exercise. Smoking causes lung damage, resulting in shortness of breath or possibly low oxygen levels with exercise, Crawford adds.

“Always ask the advice of your physician if you have concerns about starting an exercise program,” Crawford says.

As part of that conversation, talk about warning signs you should understand. Know what to do if you start to get short of breath or experience chest pain. For these reasons, supervised workouts and exercising with a partner are good suggestions to help stay safe.

You should also keep in mind some safe-exercise basics, such as:

- Stay hydrated by drinking water before, during and after your workouts.
- Warm up with some light jogging or calisthenics and some stretching before your workout, and then cool down with a brisk walk and light stretching after your workout.
- If exercising outdoors, avoid high heat and humidity, as these conditions can place strain on the heart.
- Gradually build up the time or intensity of your workouts. It’s better to do a little less than your maximum than to overdo it and be laid up with an injury.

Exercising regularly, whether you have risk factors or not, may help you avoid a heart attack or other health problems. But the key is consistency. Your goal should be to raise your overall level of fitness, rather than just get out and take a brisk walk or play a game of tennis once in awhile.

The FIT Project researchers didn’t determine whether fitter people have less severe heart attacks than those who don’t exercise, or whether physically active people have the same types of heart attacks as sedentary individuals, but simply survive them more often.

Other research has suggested that heart attack victims with greater cardiovascular fitness experience better blood flow to the heart, which helps with healing and may minimize the damaged caused by a heart attack.

Defense Against Depression

If you do experience a heart attack, not all of the damage is done to the heart muscle itself. Such a traumatic event can cause emotional injury, too. Heart attack victims are three times as likely to develop depression after an MI as people who have never experienced such an event. A heart attack can trigger worries about future health problems and death. It can also create anxiety about sex, exercise or other physical activities.

In the American Journal of Medicine study, researchers found that among the study participants, about 7.5 percent of those who exercised the most suffered from depression after a heart attack. But in the group of heart attack patients who were the most sedentary prior to the MI, more than 17 percent developed depression.

Other study findings noted that people who had been active earlier in life were still somewhat less likely to develop depression after a heart attack compared with individuals who never exercised. However, the researchers also found that older adults who exercised regularly prior to their heart attack had the best chances of avoiding depression.

Crawford believes that the protective effects of depression relate to a person’s ability to return to “normal” daily activity more rapidly because of a higher physical fitness level prior to the heart attack.

“When people can return to normalcy it helps them cope with their heart disease,” he says. “People who have a habit of exercise prior to a heart attack are more likely to return to this habit. There have been many studies showing the beneficial effect of exercise on a person’s emotional and mental well-being.”

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