How to move: with heart conditions

Heart disease, an umbrella term for conditions that impair blood flow including stroke and vascular disease, affects about 1.2 million Australians and is one of the leading causes of death worldwide.

Lifestyle factors, including exercise, are important for heart disease prevention and are vital for recovery.

While exercise can be daunting for fear of injury, experiencing symptoms or having a heart attack, Dr Angela Spence from Curtin University says it can be done safely. Getting it right could even be a life saver.

“When prescribed well, the benefits of exercise for people with heart disease can be extensive and include improved quality of life, physical performance [and] reduced risk of having another event and developing additional conditions,” she says.

During a heart attack, heart rate and blood pressure go up, explains accredited exercise physiologist Bridget Nash. Heart rate and blood pressure also go up when exercising, so this will improve the body’s ability to handle that stress.

But when being active it’s important to focus on intensity, Nash adds, as medications tend to interfere with heart rate and blood pressure response.

Before undertaking any exercise regimen or activity, consult your doctor or physician.

The move: interval training
To strengthen the heart’s ability to handle high blood pressure and heart rate, Nash recommends high-intensity interval training.

“But when I say high-intensity interval training, I don’t mean anyone with a heart condition should be signing up for the nearest F45 class,” she hastens to add. Completing a 10-second effort at a perceived exertion level of six to seven out of 10, followed by 50 seconds of complete rest and repeating a couple of times, will hit the mark while allowing the body to recover quickly. The easiest way to do this is on a bike, Nash says.

If doing longer spurts of activity, Spence recommends a lower intensity level that feels light to moderate – around two to four out of 10.

Cardio-based activity helps improve blood flow around the heart, she says but strength training is also important, as it can build muscle as well as improving self-confidence to perform activities of daily living.

Nash agrees, saying: “The importance of exercise is to increase the efficiency of the muscles to de-load the heart. A strong muscle is an efficient muscle.”

The class: dancing
Get out your dancing shoes! Nash is a big fan of dance for a social class activity. Not only can dancing be fun, but it can be a safer option without the one-on-one attention you might have with an exercise physiologist.

“A dance class, ballroom, jive or tap gets the heart rate up a little, but not an awful lot,” she says. “And it’s a great way to build some strength along the way.”

Water aerobics is also a good option, says Spence. She describes a recent study in which people with stable heart disease who took part in a 12-week water-based circuit exercise program (three 60-minute sessions a week) improved their fitness and leg strength while also reducing body fat – a key risk factor for heart disease.

The free: walking
The world’s your oyster when it comes to opportunities for free exercise, just by increasing incidental activity. “Reducing sedentary behaviours can be a great way of incorporating more activity into your day,” says Spence, “simply by modifying your habits.”

To achieve current recommendations for exercise in people with heart disease – 30 minutes of moderate intensity activity on most, if not all, days of the week – try breaking up time sitting down, listening to podcasts or audiobooks while walking, cleaning or gardening. Use active modes of transport like getting off the bus one stop earlier or parking the car further away from the shops.

Indeed, “walking will always be one of the easiest, most available and most affordable heart-healthy exercises”, Nash says.

The hard pass: too much or not enough
It could be risky exercising at a prolonged intensity rating of eight out of 10 without rest, Nash warns. She suggests not starting any new exercise without expert supervision and an individually tailored program, particularly if you have resting blood pressure of 180/100 or higher. Heart Research Australia recommends consulting a health professional if exercise feels uncomfortable or painful.