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Beginning An Exercise Routine When You Already Have Heart Disease

By Betsy Lee-Frye

Updated August 02, 2010

(LifeWire) - Exercise has many healthy benefits - including making your heart healthier. But for those who have heart disease, beginning an exercise program isn't quite as simple as pulling on those walking shoes. When the necessary precautions are taken, though, a daily 30-minute stroll can have numerous benefits.

When Exercise Is a Concern

Exercise isn't a concern for everyone with heart disease symptoms. For example, those with borderline high-cholesterol levels probably don't need to talk to their physician before beginning an exercise program.

But for those with more serious symptoms, such as a recent heart attack or stroke, it's imperative that activity be supervised by a health care professional. People with the following symptoms or criteria need to talk with a doctor before beginning a workout program:

  • Chest pain or pressure within the last month, especially if the pain occurred during or following exercise
  • Pain or pressure in your left arm or shoulder during or after exercise
  • Weakness or dizziness during or after exercise
  • Difficulty breathing during mild activity
  • History of a stroke, heart attack or any type of heart surgery
  • Use of medication for blood pressure, cholesterol or a heart condition
  • History of insulin-dependent diabetes
  • Recent, lengthy sedentary period

Benefits of Exercise

Exercise is beneficial to the health of almost everyone -- even patients with a history of heart disease.

According to the American Heart Association (AHA), regular exercise lowers blood pressure, triglyceride levels and total cholesterol levels. The AHA also reports that those who exercise regularly are less likely to be at risk for diabetes and obesity.

According to one study published in the International Journal of Cardiology, exercise reduces inflammation in people with coronary artery disease. Inflammation in the arteries can cause a condition called atherosclerosis, which greatly increases an individual's risk of heart disease and heart attack. In this study, patients participated in a 12-week aerobic training program. At the beginning of the study, 72% of study subjects had an anti-inflammatory protein level that was considered to be in the "high risk category." After the training program, only 39% of study subjects were in the high-risk category.

Selecting an Exercise Program

Selecting an exercise program is a personal decision. You need to find an activity that you enjoy and will be able to maintain. This is particularly important, because a recent study in the Annals of Behavioral Medicine found that, after a cardiac rehabilitation program, patients who were taught strategies to prevent relapse through an exercise maintenance program were 76% more likely to continue exercising.

Almost any activity will be beneficial, as long as you increase your heart rate for more than 12 minutes. Studies show that the highest cardiovascular benefit occurs when exercising between 60 to 80% of your maximum heart rate. To find your maximum heart rate, subtract your age from 220.

Walking is one great way to start an exercise program. This popular activity can reduce cardiovascular events in both women and men. A study from the Women's Health Initiative found that women who walked for a minimum of 2.5 hours per week had "a 30% reduction in cardiovascular events over a 3.2-year followup."

Some doctors may tell patients not to lift weights after a cardiac event, but a recent study published in the Journal of American Cardiology, which analyzed the effort involved in everything from closing a microwave door to lifting a ten-pound dumbbell, discovered that this prescription was too simple. Instead, the authors reported that "patients and cardiac rehabilitation specialists should work together on the activities the patients can perform safely, monitoring symptoms rather than the weight used."

Taking Precautions

Beginning slowly and listening to your body are key when starting an exercise program. Don't head out the door for a four-mile walk on your first day. Start with a one-mile walk or just try walking for 20 minutes. Add additional minutes when you feel up to a challenge.

While working out, be aware of the warning signs of overexertion. Stop and talk to your doctor if you feel light-headed or have trouble breathing after mild activity. Get medical help as soon as possible if you experience signs of a heart attack, which include excessive sweating, dizziness, shooting pain in your arm or neck and chest pain.


Adams, Jenny, Matthew J. Cline, Matt Hubbard, Tiffany McCullough, and Julie Hartman. "A New Paradigm for Post-Cardiac Event Resistance Exercise Guidelines." American Journal of Cardiology. 97 (2006): 281-6. 18 Sep 2008. <http://cat.inist.fr/?aModele=afficheN&cpsidt=17450033>.

Bassuk, Shari S., and J. Manson. "Epidemiological Evidence for the Role of Physical Activity in Reducing Risk of Type 2 Diabetes and Cardiovascular Disease." Journal of Applied Physiology. 99 (2005): 1193-1204. 16 Sep 2008. <http://jap.physiology.org/cgi/content/full/99/3/1193>.

Goldhammer, Ehud, Alon Tanchilevitch, Irit Maor, Yael Beniamini, Uri Rosenschein and Michael Sagiv. "Exercise Training Modulates Cytokines Activity in Coronary Heart Disease Patients." International Journal of Cardiology. 100 (2005): 93-9. 16 Sep 2008. <http://cat.inist.fr/?aModele=afficheN&cpsidt=16721409>.

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Moore, S. M., J. M. Charvat, N. H. Gordon, F. Pashkow, P. Ribisl, B. L. Roberts, and M. Rocco, "Effects of CHANGE Intervention to Increase Exercise Maintenance Following Cardiac Events." Annals of Behavioral Medicine. 31 (2006): 53-62. 18 Sep 2008. <http://www.ncbi.nlm.nih.gov/pubmed/16472039>.

"Physical Activity." AmericanHeart.org. 2008. American Heart Association. 16 Sep 2008. <http://www.americanheart.org/presenter.jhtml?identifier=4563>.

"Physical Activity and Health." CDC.gov. 24 Mar 2008. Centers for Disease Control. 16 Sep 2008. <http://www.cdc.gov/nccdphp/dnpa/physical/everyone/health/index.htm>.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Betsy Lee-Frye is an independent journalist living in Kansas City, Mo. Her work has appeared in The Dallas Morning News, Kansas City Magazine and Better Homes and Gardens Special Interest Publications.
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