Maintaining an Active Lifestyle for Your Heart

By Andrew Grahovec with Contributions from Alexander Brook, PT, DPT for ATI Physical Therapy

Physical activity and maintaining a healthy, active lifestyle is important for your overall health – but just how important is it? Being physically active can reduce the risk of serious noncommunicable diseases, including cardiovascular disease, diabetes mellitus and cancer. It’s important to understand why physical activity is important for your heart, how much you need on a weekly basis and what types you can perform at home or at the gym.

How important is physical activity?

A 2016 meta-analysis in the Journal of American Heart Association (JAHA) found that by increasing physical activity by 11.25 MET (metabolic equivalent – how much energy you’re expending) hours a week, the risk of cardiovascular mortality and the incidence of diabetes mellitus is reduced 23 and 26 percent, respectively. The World Journal of Cardiology (WJC) reports that physical activity can also slow the progression, lessen the impact and prevent recurrence of heart diseases. The British Medical Journal (BMJ) recognizes the association between physical activity and reduction of osteoarthritis, osteoporosis and better cognitive functioning. Cardiovascular disease is one of the leading causes of death in the U.S., but it can also be prevented or treated with physical activity.

How much physical activity do you need?

The goal of 11.25 hours a week can be broken down to a recommended 150 minutes a week (30 minutes a day for five days) of moderate intensity activity or 75 minutes a week of high intensity activity. Additional benefits can be seen with an increase up to 300 minutes a week. While these are the recommended values, any activity is better than no activity and we all must start somewhere. Gradual, small increases in activity can lead to major health benefits.

What types of physical activities can you perform?

Prior to beginning any workout plan, talk with your doctor to make sure you’re healthy enough to start a workout program. Any good workout program should consist of a warm up, the exercise and a cool down. Cardio isn’t the only way to get a good workout or reach your physical activity goal – strength training is an integral part of any good routine.

For your warm up, perform at least five minutes of low-level aerobic activities such as light walking or biking and dynamic stretching before going into your workout. After your workout, make sure to cool down for five to 10 minutes with a gradual decrease in activity and add in some stretching to stay loose. Here are some great examples of different activities you can perform for your workout:

Moderate Intensity

  • Brisk walking on the treadmill or track
  • Water aerobics
  • Bicycling (outside or stationary) less than 10 mph
  • Gardening
  • Mowing the lawn
  • Golf

Vigorous Intensity

  • Jogging/running
  • Swimming laps
  • Hiking
  • Lifting weights
  • Jumping rope
  • Competitive/organized sports

While this is in no way a full or comprehensive list, it gives you an easy way to start increasing your activity levels and becoming a healthier you.

Are aches and pains getting in the way of your daily activities or from starting an exercise program?

Stop by your nearest ATI Physical Therapy clinic for a complimentary screening and get back to doing you. Our experts will listen to your concerns, evaluate your injury and create a safe and effective plan to help you reach your goals and live a healthy, active lifestyle.

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The Role of Tissue Grafts in Sports Medicine

One Donor, Eight Lives - How Checking a Box Can Bring Life - Gift of Hope

Kevin Cmunt, President/CEO for Gift of Hope Organ & Tissue Donor Network and  Shannon Wyatt, Donation Specialist for Gift of Hope Organ & Tissue Donor Network discuss the role of tissue grafts in sports medicine as well as the how we can all participate in honoring ‘The Gift of Donation’.

It’s often said that a single person who is willing to donate his or her organs after death can save up to eight different people. That’s because there are eight major organs that can be donated: the liver (which can be split and used to save two people), the heart, the pancreas, a pair of kidneys and a pair of lungs.

Needless to say, signing up to become an organ donor may be one of the most impactful decisions a person can make in his or her lifetime. Consider the fact that every 20 minutes someone is added to the national transplant list, and that around 20 people die every day waiting for a transplant that never arrives. Hopefully this crystallizes just how important such a gesture of generosity is in helping people who are suffering from all kinds of illnesses.Gift of Hope Logo

What Kinds of Organs Can Be Donated?
As we said earlier, there are eight major organs (the lungs and kidneys are counted twice since they come in pairs) that can successfully be transplanted. Click here for closer look and see what characterizes each type of transplant.

J. Kevin CmuntKevin Cmunt is President/CEO of Gift of Hope Organ & Tissue Donor Network. In that role, he provides overall leadership for the organization, guides its strategic direction and ensures that the organization stays true to its mission — to save and enhance the lives of as many people as possible through organ and tissue donation.

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Is Weightlifting Good for Your Heart? If Yes, How Much Is Enough?

Aerobic exercise, such as running, reduces the risk of cardiovascular disease events like heart attack or stroke; thus, it is commonly called “cardio” exercise. Weightlifting has been traditionally considered to improve sports performance in athletes. Yet, limited evidence exists to clarify whether weightlifting reduces heart attack or stroke risk, which represents major causes of death in the general population. In this study, the researchers investigated the possible relationship between resistance exercise with the risks of developing cardiovascular disease and premature death.

Preventive health exam records of 12,591 adults (average age 47) provided the data for this study. The study found even doing weightlifting exercises one time per week (or less than one hour/week) reduced the risk for a heart attack or stroke by 40-70 percent. This was true regardless of whether or not the subjects reported participating in aerobic exercise! This study fills an important knowledge gap about the benefits of weightlifting–supporting that it may reduce risk of heart attack or stroke, beyond the well-documented benefits of aerobic exercise

View the abstract

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Caffeine May Increase Cardiovascular Risk During Exercise

Regular exercise is known to be good for heart health, but the risk of a heart attack temporarily increases during an exercise session. Most heart attacks and strokes are caused by a blood clot that disrupts blood flow to the brain or heart. During exercise, there is an increase in the amount of certain proteins in the blood that promote blood clot formation.

At the same time, there is typically an increase in other proteins that are responsible for dissolving a clot. It is believed that this balance between clot formation and dissolution is important for preventing a heart attack. Caffeine is widely consumed by many people and can be used to improve athletic performance. However, caffeine may affect the heart and blood vessels in ways that are not healthy for some people.

This recent study conducted by scientists at Ball State University studied 48 young healthy men, evaluating the effect of caffeine on markers of blood clotting potential–with measures taken before and after exercise. This study showed that a single dose of caffeine increased blood clotting activity during exercise more than a placebo, but caffeine did not affect the proteins that dissolve blood clots. These results suggest caffeine may cause changes in the blood that promote clot formation and, thus, increase cardiovascular risk during exercise.

View the abstract

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What Your Heart Rate Means to Your Health

By Andrew Grahovec with Contributions by: Abbey Corcoran, PT, DPT for ATI Physical Therapy

With every movement and minute of exercise your body goes through during the day, your heart doesn’t always beat with regularity. If healthy, your heart will adjust to the speed of your daily activities to accommodate the need for oxygen, but this may not be the case for everyone. Each individual’s body has its own way of adjusting to their activities, but an unusually high- or low-resting heart rate could be cause for concern. Knowing your pulse, at rest and during exercise, can help identify potential risks for heart attacks or diseases. One way you can do your heart a favor and help decrease these risks is by having good cardiorespiratory fitness.

Cardiorespiratory fitness refers to the ability of the heart and lungs to supply the exercising muscles and tissue with oxygen-rich blood during physical activity. Having good cardiorespiratory fitness can help decrease your risk for cardiovascular disease and stroke. According to the American Heart Association (AHA), a person dies every 38 seconds from cardiovascular disease. Living a healthy and active lifestyle can lead to a healthy heart, decrease your risk of cardiovascular disease and help your overall health and well-being.

Assessing your heart rate

One way to assess how well your heart is functioning is by monitoring your heart rate. A normal resting heart rate ranges from 60 to 100 beats per minute (BPM). To determine your resting heart rate, place your middle and index fingers on the thumb side of your wrist. There, you will find a pulse and you can count the beats. You can count the number of beats within a 10 second timeframe and multiple that number by six to find your resting heartrate. In a healthy individual, your heart rate can reveal how efficient your heart is working.

Your heart rate is determined by how efficiently your heart pumps blood throughout your body per beat. There are four chambers in your heart that help with this process, however, the most important chamber for determining your heart rate is the left ventricle. The left ventricle is responsible for pumping oxygen-rich blood to the entire body. If your left ventricle can pump a larger volume of blood throughout your body per heartbeat, then it will take fewerbeats per minute to distribute the same amount of blood.

Endurance athletes, such as marathon runners and cross country skiers, who have very high cardiorespiratory fitness, have a stronger and larger left ventricle. This makes it possible to pump out higher volumes of blood with each beat resulting in a lower resting heart rate due to the fewer beats per minute to pump out the same amount of blood through the body. This allows endurance athletes to have resting heart rates as low as 40 bpm. The lower your resting heart rate is, the more efficient your heart is working.

Is your resting heart rate high?

If your resting heart rate seems irregular, it may not be time to run to a doctor just yet. Resting heart rates can be affected by many factors including air temperature, emotions and medication. Higher air temperatures and humidity levels increase your heart rate to help keep your body cooler. According to the Cleveland Clinic, heart rates increase by 10 bpm for every degree your body temperature elevates. Emotions such as excitement, surprise and anxiety can also elevate the heart rate due to the activation of your sympathetic nervous system (SNS). Your SNS is responsible for the “flight or fight” response and increases body responses, like your heart rate. If your heart rate seems too low or too high, check your medication to see common side effects that may influence heart rate and consult your doctor.

Lowering your resting heart rate

Regular exercise can help decrease your resting heart rate. The American College of Sports Medicine (ACSM) recommends at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week for adults or a combination of the two. “Moderate” exercise is categorized as exercising at 65 to 75 percent of your max heart rate and “vigorous” exercise is 76 to 95 percent of your max heart rate. To determine your maximum heart rate, take 220 and subtract your age. Then, multiply that number by 0.65 and 0.75. This will give you two numbers, the range you need to be considered exercising at a moderate intensity level. For example, if an individual was 50 years old, their predicted heart rate max would 170 beats per minute (220-50) and their heart rate zone for moderate intensity exercise would be 111-128 beats per minute. If you are just beginning to exercise, start in the lower ranges such as 65 percent to improve your tolerance to the exercise program then slowly work your way up.

Beginning a new exercise program can be intimidating, especially if you have various health conditions. If you are unsure where to begin, you can see your local physical therapist. Our trained staff are experts in prescribing exercise programs to a variety of health conditions.

Are aches and pains getting in the way of your daily activities or starting an exercise program?

If simple home interventions are not helping to lessen aches, pains and discomfort, it’s time to see a physical therapist. Stop by your nearest ATI Physical Therapy clinic for a complimentary screening and get back to your regular exercise routine.

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Heart Health & Brain Health Go Hand-in-Hand

According to the Center of Disease Control and Prevention, heart disease accounts for one of every four deaths in the United States. Many of the causes of heart disease are well-known, including hypertension, hyperlipidemia, diabetes and obesity. Fortunately, there are also well-known lifestyle and behavior changes that can drastically reduce the risk of heart disease and include: smoking cessation, eating a healthy diet and exercising.

Despite the multitude of data showing that lifestyle behaviors can reduce the risk of heart disease and improve cardiovascular health, the Framingham Offspring Study recently reported that the percentage of people with ideal cardiovascular health (using the American Heart Association’s definition of Ideal Cardiovascular Health) has declined over the past 20 years.

Even in the absence of heart disease, the increasing percentage of Americans with less than ideal cardiovascular health translates to greater risk of heart disease and increased all-cause mortality. Because the heart and cardiovascular system are vital factors in overall health, other organ systems will be affected by less-than-ideal cardiovascular health. Importantly, adults having an ideal cardiovascular health score during the middle-aged years had a lower risk of cognitive decline and dementia. In addition, large-scale epidemiological studies have continued to show a strong correlation between cardiovascular health and brain health.

What is the link between cardiovascular health and brain health?

It is possible that heart disease and Alzheimer’s disease or dementia have common risk factors and that is why there are correlations between these conditions. However, the brain requires a large amount of blood flow, which needs to be precisely controlled to maintain optimal neuronal function. If a patient has a problem with the function of the heart or blood vessels, this could prevent adequate blood flow supply to the brain and eventually affect brain function and cognition. We know that patients with congestive heart failure have higher incidence of dementia. In heart failure patients, a reduced capacity of the left ventricle to pump blood (i.e. ejection fraction) is associated with poor cognitive test scores.

The function of the large vessels supplying blood flow to the brain are also important to overall brain health. A paper published almost 70 years ago first reported that patients with carotid occlusion (due to atherosclerosis) eventually progressed to dementia. This early case study was the first to suggest that mild hypoperfusion of the brain, due to large vessel stenosis, could lead to dementia.

Dysfunction in the heart (or pump) or the large blood vessels (or conduits) is associated with reduced cognitive function, but the small blood vessels in the brain that control the blood supply to neurons may also contribute to the link between cardiovascular health and brain health. This hypothesis was first proposed decades ago, based on evidence of disrupted microvessel structure in the brains of Alzheimer’s disease patients. Disruption in the microvessels can lead to hypoperfusion, disrupt the blood-brain-barrier or reduce the ability of the brain to utilize glucose. Collectively, an interruption at any segment of the blood delivery system (heart, large and small blood vessels) could impair the ability of the brain to function optimally.

physical activity recommendationsNow, for the good news: Because of the link between heart health and brain health, we know that lifestyle behaviors (like exercise!) can reduce the risk of developing heart disease AND developing cognitive decline. Older adults who are more physically active have better brain health compared with sedentary counterparts, suggesting a protective effect of exercise. And although more research is necessary to determine how exercise may promote healthy brain aging and what might be the optimal training program, using what we know about what works for heart health and following ACSM’s guidelines for physical activity is a great place to start. Remember to take care of our heart so that our heart can take care of our brain.

By: Jill Barnes, Ph.D., FACSM, is an Assistant Professor at the University of Wisconsin-Madison in the Department of Kinesiology and has an affiliate faculty appointment in the Division of Geriatrics and Gerontology in the School of Medicine and Public Health.

Related Article: Heart disease and brain health: Looking at the links

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