Wednesday, June 12, 2019

Staying Active During Heart Attack Recovery Can Decrease Risk of Death by 30%

Regular physical activity is good for everyone, even those who’ve had a heart attack.
A brisk walk for 30 minutes a day may help decrease the risk of death by nearly 30 percent.
For people who’ve had a heart attack, they should talk to their doctor about when it’ll be safe to resume physical activity.

It’s never too late to start exercising — even if you’ve had a heart attack.

In fact, a new study shows that exercising regularly after you’ve recovered from a heart attack can lower your risk of dying.

Physical activity is also safe for most people, with benefits seen even from brisk walking for just 30 minutes a day.

“This study provides additional evidence that regular physical activity — such as a structured cardiac rehabilitation program — is a key part of maintaining wellness after recovery from an acute event [such as a heart attack],” said Dr. M. Wesley Milks, medical director of cardiac rehabilitation at The Ohio State University Wexner Medical Center, in Columbus, Ohio, who wasn’t involved in the study.

Exercise works after heart attack

In the study, researchers from Harvard University examined data on more than 1,500 male survivors of a heart attack. The men were followed for about 14 years as part of the Harvard Health Professionals Follow-Up Study.

Researchers found that men who increased their physical activity from a low level before a heart attack to a high level afterward were 27 percent less likely to die from any cause, compared to men who stayed at a low level.

This was true only for men who continued to exercise at the higher level for more than a few years.

“Those who only participated in exercise shortly after the heart attack and then petered out did not have these survival benefits,” said Dr. Victoria Shin, chair of the cardiology division at Torrance Memorial Medical Center, in Torrance, California, who wasn’t involved in the study.

Researchers classified a “high level” as at least 2.5 hours a week of moderate to vigorous physical activity. This is the minimum recommended by the Physical Activity Guidelines for AmericansTrusted Source.

Men who were high-level exercisers before their heart attack and were able to resume that level afterward benefitted even more: They were 39 percent less likely to die from any cause, compared to low-level exercisers.

In addition, men who walked at least half an hour a day after their heart attack were 29 percent less likely to die. That’s 210 minutes a week, which exceeds the physical activity recommendations.

How fast men walked after their heart attack also mattered: The faster their pace, the lower their risk of dying.

The new study didn’t include women, although the results are similar to an earlier study done in postmenopausal women.

Most of the participants in the new study were also non-Hispanic, white healthcare professionals, so the results may not apply to other groups of men.

The researchers presented their results Nov. 11 at the American Heart Association meeting in Philadelphia. The study hasn’t yet been published in a peer-reviewed journal.

Is it safe to exercise post-heart attack?

Steven Keteyian, PhD, director of preventive cardiology in the division of cardiovascular medicine at Henry Ford Medical Group in Detroit, Michigan, said regular exercise after a heart attack is “immensely important.”

“The standard medications that we use after a heart problem — statins, beta blockers, ACE inhibitors — are very important,” said Keteyian, who wasn’t involved in the new study. “But regular exercise after a heart attack stacks up extremely well against those drugs, in terms of an equally beneficial effect.”

He emphasized that exercise isn’t a replacement for these drugs, but should be used alongside them to improve heart health.

People who’ve had a heart attack should talk to their doctor about when they can safely start an exercise program. It can take several months to reach your exercise goals.

But Keteyian said that after recovering from a heart attack, physical activity like brisk walking, jogging, bike riding, or working out in the gym are “very tolerable and safe for most everybody.”

However, there are some people with other complications — such as an irregular heart rhythm or heart failure — who’ll need to wait for the go-ahead from their doctor before increasing their physical activity.

But for those who are given the green light to get moving, some may even be able to progress to high-intensity interval training (HIIT)Trusted Source. Although that intense exercise isn’t for everyone.

“I’m the first to say that there are many people who would not tolerate high-intensity interval training or maybe don’t want to do it,” said Keteyian. “But I wouldn’t want them to stop all exercise because of that.”

Cardiac rehab offers exercise support

  1. Milks recommends that people who’ve had a heart attack enroll in a cardiac rehab program, a move also supported by the American Heart Association and American College of CardiologyTrusted Source.
  2. “Unsupervised return to exercise after a heart event or working with an unlicensed trainer has the potential to overshoot or undershoot the right amount of exercise for an individual person,” said Milks.
  3. If you live in an area without a cardiac rehab program nearby, a home-based program could be an option.
  4. Shin said cardiac rehab programs offer many benefits for people who’ve had a heart attack.
  5. Staff closely monitor people as they increase their level of physical activity, and customize the exercise to fit the person’s needs.
  6. And even though everyone may be working at their own pace, “It helps to have the camaraderie of other cardiac patients,” said Shin.
  7. In spite of these benefits, only a small number of people take advantage of these programs. One study found that 16.3 percent of Medicare enrollees participated in a cardiac rehab program after a heart attack or other major coronary event.
  8. There are many reasons why people don’t enroll in a cardiac rehab program — from being overwhelmed after a heart attack to not feeling comfortable exercising.
  9. For people who may cringe at the term “workout,” Milks said exercise doesn’t have to involve “spandex workout clothing and gym membership fees.”
  10. Walking briskly, playing doubles tennis, or raking the yard all count as moderate-intensity physical activity. And running, shoveling snow, or carrying heavy groceries upstairs can all bump you up to the vigorous level.

Don’t wait to get active

  • The new study also highlights the importance of not waiting for a heart attack before making regular physical activity a part of your life.
  • This is especially true if you have risk factors for cardiovascular disease, such as high blood cholesterol, high blood pressure, or have overweight or obesity.
  • Shin said in addition to controlling these risk factors with diet and medications, people can benefit from doing at least 2.5 hours a week of moderate to vigorous physical activity.
  • “This will reduce their risk of heart attacks in the first place,” said Shin. “But also if they were to have a heart attack, it will reduce their risk of dying from that or other causes thereafter.”

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