How Exercise Can Prevent and Reverse Heart Disease
Heart disease is a systemic cardiovascular disease that can lead to serious cardiac events, such as high blood pressure, heart attack, heart failure, and heart rhythm abnormalities. Regular exercise not only can help prevent the onset and development of cardiovascular disease but also is a critical therapeutic tool to improve outcomes for those with heart disease. As individuals adapt to the healthy stress that exercise places on the heart and body, the heart becomes stronger; it takes fewer beats to push blood through the body, leading to a lower heart rate and a healthier heart and cardiovascular system. Physical therapy can help reduce the risk of developing heart disease and improve the function of those with heart disease through a personalized exercise program to improve aerobic capacity, strength, and endurance safely.
What is Heart Disease?
Heart disease is a systemic cardiovascular disease that can lead to serious cardiac events, such as high blood pressure, heart attack, heart failure, and heart rhythm abnormalities. In 2017, heart disease caused 859,125 deaths and is the leading cause of death globally.
Heart disease is a silent disease and often is not diagnosed until someone experiences heart failure, a heart attack, or has an abnormal heart rhythm. Risk factors for heart disease can include hypertension, disease of the coronary arteries (atherosclerosis, or plaque buildup in your arteries), history of a prior heart attack, family history of heart disease, cigarette smoking, a sedentary lifestyle or lack of physical inactivity, increased BMI or being overweight, high cholesterol, diabetes, women over age 55, or men over age 45.
A heart attack occurs when the flow of blood to a section of the heart is blocked, typically due to coronary artery disease when plaque builds up on the arterial wall. If blood flow is not restored, that section of the heart can die. Symptoms include chest pain, pain in the arm, shoulder, neck, jaw, and abdomen, shortness of breath, fatigue, nausea and dizziness, and racing heart palpitations.
Heart failure affects 6.2 million Americans over age 20 and is a syndrome in which the heart fails to meet the needs of the body; the heart is unable to pump blood effectively, so the body does not get enough blood and oxygen. The body then compensates over time to provide enough blood and oxygen to vital organs, leading to symptoms of fatigue, shortness of breath, lower extremity swelling, pulmonary congestion, weight gain and decreased exercise tolerance.
How Exercise Can Prevent & Reverse Heart Disease
Regular exercise not only can help prevent the onset and development of cardiovascular disease but also is a critical therapeutic tool to improve outcomes for those with heart disease. When exercising, particularly for aerobic exercises like walking, swimming, or cycling, the heart must pump more blood through the body, increasing cardiac output and blood pressure. Over time, as individuals adapt to the healthy stress that exercise places on the heart and body, the heart becomes stronger and it takes fewer beats to push blood through the body, leading to a lower heart rate.
Exercise alters the lipids in your blood, increasing HDL cholesterol (the “good” cholesterol) concentration and particle size while reducing triglyceride levels, both of which reduce the risk of heart disease. During exercise, insulin levels are reduced as contracting muscles exhibit greater glucose uptake, improving overall insulin sensitivity. Exercise also improves arterial function, reducing blood pressure and thickening the ventricular chamber walls of the heart.
Research has shown that regular exercise is associated with decreased markers of inflammation, improved metabolic health, enhanced insulin sensitivity and mitochondrial function, decreased circulating lipid concentrations, improved vasculature, and decreased heart failure risk. These health benefits of exercise occur through adaptations in the heart and arteries, skeletal muscle, liver, and adipose (fat) tissue.
Multiple research studies have shown the benefits of exercise in preventing and reversing heart disease:
Individuals who are the most physically active have heart disease rates 50% lower than those who are sedentary.
Women who committed to regular brisk walks raised their HDL cholesterol levels and had a 50% reduction in cardiovascular events like a heart attack.
A meta-analysis of 52 exercise training studies with 5,000 subjects showed reductions in triglyceride and LDL (“bad” cholesterol) levels.
Patients who have had a heart attack in the last year underwent a personalized aerobic exercise rehabilitation program after heart surgery. These patients had increased exercise tolerance, improved heart function, and reduced cardiovascular risk factors six months after starting the exercise rehabilitation program.
A systematic review of 63 studies found that exercise-based cardiac rehabilitation improved cardiovascular function in those who have heart disease, reduced heart disease-related morbidity, decreased the risk of a heart attack, and improved the quality of life of the patients.
A study of 12,591 people found that weekly strength training was associated with a 40-70% decrease in heart disease risk factors. The benefits of strength training for heart health are even greater when combined with aerobic exercise.
How A Physical Therapist Can Help
Physical therapists are musculoskeletal experts that are trained to help patients increase their exercise tolerance safely. Physical therapy can include:
Education on how to gradually increase exercise capacity and recommended lifestyle changes, such as healthy eating habits.
Aerobic endurance training: Aerobic exercise involves working your large muscle groups, which increases your heart rate and makes you breathe faster. Aerobic exercise can involve walking on a treadmill, using a stationary or recumbent bike, or aquatic therapy exercise in a warm water therapy pool. The therapist carefully monitors the patient, ensuring their heart is not placed under too much stress while gradually building up to longer intervals of aerobic movement.
Strength training: Strength training involves lifting weights or using body weight to increase muscle mass. Strength training also works your heart muscle, temporarily increasing your heart rate and blood pressure levels. Strength training can also speed up the body’s metabolic rate and decrease the amount of visceral fat in the body (fat that sits around vital organs).
Improving breathing ability during activity: The therapist also monitors your breathing and ability to speak while exercising. Aerobic exercise helps strengthen your lungs as well; being able to sustain talking while exercising is a good indicator of the patient’s tolerance of the exercise.
Heart disease is a silent disease that greatly affects your quality of life and physical function. Work with a physical therapist today to take back control of your health, improve your exercise tolerance and prevent or address heart disease!
