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People who have a heart problem, even though they are feeling well most of the time, have fears.  In particular, there is fear that physical activity, of “overdoing it”, could cause heart symptoms and even damage the heart.

It is true that some extreme forms of exercise, because it can raise the heart rate and blood pressure very high, can be dangerous for a heart patient.  These include activities like shoveling a great deal of snow in the wintertime, mowing a large lawn for hours in the intense heat of summer, or heavy weight lifting.  

Most cardiologists strongly recommend regular physical exercise to their patients. In 2007, the American College of Sports Medicine and the American Heart Association recommended for all people age 18 to 65, a regimen of 30 minutes of moderate exercise 5 days a week, or intense exercise 20 minutes 3 days a week.

But did this advice apply to patients with coronary artery problems or who have a heart attack in the past?  In a study published March 13, 2018 in the Journal of the American College of Cardiology (volume 71, no. 10, p. 1094-1101), I think we have the answer.

Trine Moholdt, PhD and colleagues in Norway followed the lives of 3,307 people with a history of coronary artery disease or a heart attack for 30 years.  Two-thirds were men, and one-third women. They wanted to see if weight gain or loss, and the level of physical activity had an effect on how long people lived.

The results were surprising regarding the weight effect.  Gaining some weight was NOT associated with a lower chance of living!  In fact, in those who had normal weights at the beginning of the study, LOSING WEIGHT gave a higher chance of not living to the end of the study.  

The effect of exercise, however, was positive.  Compared to people who described themselves as “inactive,” those who participated in regular and sustained but low level physical activity, had an almost 20% reduced risk of dying.  In those who reported high physical activity levels, this reduced risk was just short of 40%!

Heart doctors like to use medicines, and the benefits of many of them are life saving.  But caring for you and heart is a joint effort of your heart specialist and you. Regular physical activity, discussed with your doctor, can also be life saving. It might even be more important than losing a few pounds. Use it or lose it!

Dr. Arnold Meshkov

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