John Maloof, M.D.,
board-certified cardiologist, Williamson Medical Center
Even though heart
disease and cardiovascular issues are prominent in our country, there is some
good news: We are seeing fewer heart attacks. In fact, a study at Yale School
of Medicine found that from 1999 to 2011 hospitalizations for heart attacks
dropped 38 percent.
This is partly due to
the fact that fewer people are smoking and partly due to the increased use of
cholesterol-lowering drugs. I wish that I could say it is because our society
is getting healthier, but that’s not something I can say — at least not yet.
Obesity on the rise
According to recent
statistics from the National Institutes of Health, close to 70 percent of
American adults are considered overweight or obese. That means that excessive
obesity is leading to more high blood pressure, cholesterol abnormalities,
diabetes and — ultimately — more heart disease. We are just a very sedentary
society, which is why we are seeing so much obesity.
Every step you take
It’s not news that the
key to reducing obesity — and all the ancillary diseases that stem from it — is
exercise. But it’s worth repeating. Exercise is good for all parts of your
body, not just your heart. It’s good for your waistline, your mind and even
things like your blood sugar. And keep in mind: Exercise doesn’t have to be
vigorous. As long as you can walk 15 to 30 minutes a day, you are doing a great
job for your heart and the rest of your body. Do you have any idea how many
steps you take in a day? I advise people to get a pedometer so they can see.
Once you know, then you can try to increase that number.
If you’re looking for
something a bit more strenuous than walking, I recommend any aerobic exercise,
including cycling, swimming or running.
Know your resting heart
rate
Getting your heart rate
up during exercise is important. One indicator of heart health is called the
resting heart rate. The average person’s heart beats between 60 and 100 times
per minute. Highly trained athletes will have a normal resting heart rate of 45
to 50. It’s highly variable, but generally the lower your resting heart rate
the more efficient your heart is.
What that means is that
if your heart is in good condition it is pumping larger amounts of blood with
each beat, so it doesn’t have to pump as fast. But it’s important to know that
it is a variable number. It won’t stay the same. When you stand up, your heart
rate goes up. When you sit down, it will go down. It goes up after you eat, and
so on.
The best way to
determine your resting heart rate is to count the number of times your heart
beats for 15 seconds and multiply that number by four. You can feel the beats
really strong in your neck, just under your jaw bone. Don’t do the measurement
when you are stressed as that that will affect the results and you won’t get an
accurate resting number.
Blood pressure reading
Another important
measurement to watch is your blood pressure, which isn’t correlated with your
heart rate. (They are two completely different indicators.) Your blood pressure
is also highly variable, and, oddly enough, will be highest when you first wake
up, which seems counterintuitive. If you’re monitoring your blood pressure, it
doesn’t matter if it’s normal during the day and high in the morning. To say
that your blood pressure is controlled, you must have your early-morning blood
pressure controlled.
In contrast to your
heart rate — which is simply the number of times your heart beats in a minute —
your blood pressure numbers measure force. The systolic number (the top one)
measures the pressure as your heart beats and forces blood into your arteries.
The diastolic pressure (the bottom number) measures the pressure as the heart
relaxes between beats.
Normal blood pressure
is extremely important because high blood pressure can be a silent killer.
Everyone needs to monitor their blood pressure; if you don’t, you could die
from kidney failure caused by your high blood pressure.
Is medication the
answer?
If you do have high
blood pressure, there are medications you can take to help control it. And,
yes, you will more than likely take them for life. But you can also try to lose
a few pounds. In general, you should have two to three separate blood pressure
readings. If the readings are elevated, take the medications. Then try to
modify your lifestyle and maybe reduce the medication.
Modified exercise
With high blood
pressure, you can do any kind of aerobic exercise, but avoid anything that is
isometric (where you are pushing against a fixed weight), as isometric exercise
can raise your blood pressure. Think about it: If you’re pushing hard against a
really heavy weight, you are going to get red-faced, which will make your blood
pressure go up, which, in turn, can exacerbate high blood pressure overall. You
really need to do something where you are moving.
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