Coronary Heart Disease (CHD) is the leading cause of death in Australia and it is estimated that over 20% of CHD worldwide is due to lack of physical activity. Exercise is an effective tool in both the prevention and treatment CHD, with recent research indicating that exercise may be as effective as pharmacological agents in the secondary prevention of CHD.
Exercise provides a therapeutic effect via a number of mechanisms. These include its positive effect on myocardial oxygen demand, endothelial function, clotting factors and inflammatory markers. Exercise can also play an indirect role by influencing the risk factors for CHD including cholesterol levels, blood pressure, obesity and hyperglycaemia. In addition to this, exercise improves general physical functioning and psychological wellbeing.
The National Heart Foundation recommends patients with CHD do 30 minutes of moderate intensity physical activity on most if not all days. Moderate intensity means that exercise should cause a slight increase in breathing and heart rate and perhaps some sweating. For those who experience exertional angina, exercise intensity should be at a level where their heart rate stays at least 10bpm below the level at which they experience angina symptoms. Many individuals with CHD may also have reduced strength, therefore resistance exercise is beneficial in order to maintain function and improve wellbeing.
Barriers such as deconditioning, time and motivation may make it difficult to do a full 30 minute bout of exercise at a time. However this can be overcome by accumulating 30 minutes of exercise by doing short 10 minute bouts of activity. Incidental activity can also play a significant role in achieving exercise guidelines. Unfortunately many people don’t know where to start when it comes to taking up regular physical activity. When they think of exercise they think of people slogging it out on reality TV show such as “the Biggest Loser” or they think of gyms full of beautiful fit people. For many individuals with CHD this can put them off exercise. But the reality is a quick 15 minute walk on a lunch break plus throwing the footy in the backyard with the kids, then doing some vigorous housework such as mowing or vacuuming are all legitimate ways of accumulating 30 minutes of physical activity.
An accredited exercise physiologist (AEP) can provide tailored assistance and education regarding appropriate exercise for an individual with CHD. AEP’s are also trained in implementing strategies to help people take up regular exercise and stick with it in order to make the most of the therapeutic benefits of exercise.