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Importance of exercise in cardiovascular fitness

A regular exercise program is highly essential for general as well as cardiovascular fitness. It is useful for any individual who is capable of exercise. For a person with heart disease the exercise program has to be planned in consultation with the treating doctor. Ideally if you are planning to start a strenuous exercise program after the age of 40 years, it will be better to exclude cardiac illness by medical evaluation and a treadmill stress electrocardiogram.

Even though blood pressure and heart rate increases during exercise (see cardiovascular response to exercise), a regular exercise program brings down the blood pressure, blood sugar and cholesterol levels if they are mildly elevated. Severe elevations require additional medical treatment. Regular exercise brings down the body weight and reduces the risk of cardiovascular illness.

Types of treadmills for home exercise

Basically there are two types of treadmills for home exercise. The simplest is a mechanical one which does not require any electrical connection. The treadmill belt moves with the effort of the runner so that a motor is not needed. The speed is variable depending on the effort put in by the runner. It does not have many controls and is much cheaper than a motorised treadmill. Naturally the effort needed to run a purely mechanical one is more for any given speed. One potential disadvantage is the higher strain to the lower limb joints.

The motorised treadmill is very convenient if you can afford one. Various sophisticated controls are available depending on the cost you are ready to pay. The speed can be varied continuosly and so can the gradient or slope. Sensors for checking the pulse rate are available. The exercise time, speed, distance run and calories spent are all displayed in front of you. A word of caution about the calories displayed. The calories spent will depend on your weight, being higher for a heavier person. But the most machines do not check your weight and only the calories spent for an average person at that particular speed and incline are displayed, as a function of the time run.

Taking away the boredom of treadmill exercise

Music can take the boredom out of exercise

Photo by Andrew*

If you walk or run outdoors for your daily exercise, each day you can take a separate route and can watch the activities around and enjoy the fresh breeze. You lose out on all these in a home treamill exercise. After the initial enthusiasm wanes off, treadmill exercise can turn out to be a real bore.

So how to get away with it? Some finish their morning newspaper reading during the treadmill time. But this is not easy unless you provide a good stand for reading the paper and have some mechanism of turning the pages. Reading small print would not be ideal thing to do while moving on a treadmill in view of the eye strain it is likely to produce. A much simpler way is to watch music or an interesting program on televsion. Some use just a walkman or ipod to listen to music.

How to plan your exercise program?

For cardiovascular fitness, at least 30 – 40 minutes of exercise for 5 days a week are required. Average calories spent per week should be not less than 1000 KCal. For a beginner, start low and gradually increase timing and speed over a few weeks till you reach the maintenance phase. This will help to tune up your body. Every day the program should consist of an initial warming up and a final cooling down phase of slow speed. Any exercise program has to be maintained life long to remain effective. Hence choose the maximum speed judiciously. Dont try to overdo it – you wont be able to maintain it. Dont forget to use a good sports shoe or else your sole skin will be damaged soon and come out as blisters.

In the study conducted in about 14000 persons who had a heart attack, it was found that people who developed depression were 4 times more likely to develop heart failure and die than those without depression. Also antidepressants were not found to reverse these effects.

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ECG Pattern in Brugada Syndrome.

A new medical report suggests that those with a vitamin D deficiency are at a higher risk of having a heart attack or contracting a cardiovascular disease.

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Hormone replacement patches were found to decrease risk for heart disease upto 40%

Women tend to have a lower risk for heart disease. But all that changes after menopause. Estrogen – the hormone reponsible for the feminine characters – also helps to decrease the heart disease risk in women. But after menopause, when the estrogen production decreases dramatically, the risk for having a heart attack also rises. This change in hormone production is also responsible for what is known as post menopausal syndrome, which includes hot flashes, head ache, stomach upset, fatigue and anxiety.
Hormone replacement therapy (HRT) is a system of  supplementing the hormones so as to alleviate the symptoms experienced by post menopausal women. The various methods of hormone supplementation include estrogen pills, estrogen and progesterone pills, patches, vaginal gels etc. Earlier research ( The Women’s Health Initiative Study conducted in the US on nearly 20,000 post menopausal women.) suggested that long term use of HRT (more than 4 years) significantly increased the risk for breast cancer and heart disease. 
But a new study published in the European Heart Journal conducted on 700,000 Danish women over 50 suggests that hormone patches and gels are safer than the hormone pills that are mostly in use in America.
It was found that while women who took estrogen plus progesterone pills had increased risk of heart attacks by upto 35%, those who used hormone patches and vaginal gels had nearly 40% lower risk of heart disease. Thus HRT patches and gels provide a safer alternative for combating the symptoms of post menstrual syndrome.

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According to the American Heart Association, people with heart disease have a high risk of depression.

Living with heart disease is not easy. Having an episode of heart attack can be devastating for many people. Temporary feelings of sadness are normal and most people get back to their normal routine within a few weeks. But if these feelings persist beyond a few weeks, this can have serious impact on the quality of life.

Heart attack patients are three times more likely to suffer from depression than their healthy counterparts. Studies have found that 15-20% of patients hospitalised with heart attack show signs of depression. People with depression often forget to take their prescribed medications, have a poor diet, forget to exercise and in general, do not stick to a heart healthy lifestyle. About 16 million people have heart disease in the U.S., including 8.1 million who have suffered a heart attack.

The persent recommendations suggest that people with heart disease should be screened for depression by their doctor. Those showing signs of mood disorder should be referred to a mental health professional. Proper management of depression can help the person to return to their normal routine and significantly reduces the chances of a second episode of heart attack.

World heart day is celebrated on the last Sunday of September every year. This year it is 28th September, 2008. The celebrations were initiated by World Heart Federation in order to foster a heart healthy life style for reducing the risk of heart disease. Various programs are conduction globally and details are posted on the federation website. Anyone planning to organise programs can submit the details at the website: world-heart-federation.org 

Theme of the year: “Know Your Risk”

Every year the World Heart Federation announces a theme for the celebrations. The theme of this year’s World Heart Day Celebrations is ‘Know Your Risk’. It is meant to help people get a better understanding of their personal risk for cardiovascular disease, including high blood pressure (hypertension). Screeing for risk factors is an important aspect of this program. Screening programs will be held in over hundred countries. These will be along with public awareness programs which will include lectures, demonstrations and video / slide shows.

How can you get involved?

As the first step you can check for the World Heart Federation (WHF) member in your country on local activities and ways to collaborate with them. Details of member societies in your country are listed on the federation website.

If there is no society in your country which is a member of the federation, you can look out for those with similar interest in prevention of cardiovascular disease and start a society of your on. WHF members can access the members area of the federation website for a lot of useful information including press releases, newsletters and promotional material.

Once affiliated with WHF, your society’s activity can be submitted to the website for announcement to world.

What activities can be planned?

Different types of activities for spreading information on risk factors and risk factor screening can be planned. Risk factor screening for blood pressure, cholesterol, body mass index (BMI), waist circumference and blood sugar levels can be done. Free health check ups can be organised at local schools, clinics or hospitals. Free/discounted health check-ups at local clinics or hospitals. Public lectures, seminars and ask the expert sessions can be organised. Special newsletters or pamphlets can be published and distributed in places where people gather like cinemas, areas of worship or recreational spaces.

World Heart Day recreational activities encouraging physical activity can also be planned. This can be in the form of walks, runs or football / cricket matches. A swimming contest can also be good idea in feasible locations. Swimming can be considerated as one of the best form of exercise for the whole body, which does not produce much strain on your weight bearing joints, unlike jogging or running.

Special functions like demonstration of healthy food cooking or sale of subsidised healthy food can also be organised.

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Babies who are breast fed for at least six months have lower cholesterol levels in adult life, says a multi-author, multi-centre study by Dr Christopher G Owen and associates. This study analysed the data of over 17,000 adults and found that those who were exclusively breastfed had lower cholesterol than those who were fed only on formula feeds. The study summarised information from12 890 breastfed and 4608 formula-fed subjects. It was a systematic review of 17 research papers and was published in the August issue of American Journal of Clinical Nutrition ( Am J Clin Nutr 2008 88: 305-314 ). Even those who were only partially breast fed also had lower cholesterol levels in adulthood. If this lower cholesterol levels are translated into heart disease risk, initial breast feeding can be considered to protect against heart disease in adult life.

Heart Walk is the American Heart Association’s great fund raising event held annually. The aim is to promote physical activity and heart healthy living in an atmosphere of fun and family involvement. This year more than 1 million walkers will participate in more than 450 events to raise funds for saving lives from heart disease and stroke the number one and number three killers of Unites States of America. You can walk with your family, friends, co-workers or strangers and build a strong bondage. You are welcome to organise a team at work in your company along with your co-workers. The American Heart Association will honour and recognize individuals, companies and teams that have made their all out efforts in this great humanitarian venture. Top walkers, top companies and top nationwide teams are listed separately on the American Heart Association website.

Poor diet and lack of exercise are responsible for at least 25% of health care costs of working adults. Physical inactivity more than doubles the risk of heart disease. So what are you waiting for? Start walking today! Don’t forget to continue walking for at least 30  – 40 minutes a day for the rest of your life. No harm in talking one or two days off every week. But maintain the program life long and encourage your friends and family to do so. A word of caution for those who already have heart disease – please get clearance from your physician regarding the permissible level of activity.