Start slowly and be smart
		Tips for sticking with it
		Count the benefits

If you've been diagnosed with angina and coronary artery disease (CAD), regular exercise is essential for the health of your heart. If your doctor gives you the OK, try to work some exercise into your daily routine. You may reap big benefits, including lower blood pressure and less risk of obesity and diabetes—all of which are risk factors for CAD. You may also note relief from stress, more energy and endurance, and even an improved sex life.

Start slowly and be smart

If you have angina, always check with your doctor before you start an exercise program. He or she may advise you to start slowly and to gradually build up endurance and fitness. To avoid triggering an angina attack, be sure not to push yourself too hard or too fast, or to do an exercise that requires quick bursts of motion and energy. Instead, pace yourself.

The American Heart Association (AHA) suggests, for example, that patients start by walking five minutes a day, then increasing gradually to 30 minutes over several weeks. Swimming may be another good choice.¹

If you've already had a heart attack, the AHA says that physical activity is fine, but again, do not begin an exercise program unless you consult your doctor. You may need to do special tests on a treadmill or exercise bicycle first to determine the right level of activity for you.

In some cases, doctors may refer heart patients to outpatient cardiac rehabilitation programs for this type of testing, as well as for exercise training in the proper type of activity and intensity. You may need follow-up visits to see if you need a change in your exercise "prescription." Heart patients face a low risk of sudden cardiac death during exercise, but the rate is still higher than for people without heart disease.

You may know that exercise is good for you, but perhaps you're afraid that a workout will trigger angina. Because cardiac rehabilitation units run tests to see how much exercise you can handle, they are good resources for people who fear that exercise will bring on pain. Ask your doctor if you should have one to gauge your physical fitness. Talk to your doctor, too, about what precautions you should take before exercising to prevent angina pain.

Tips for sticking with it

Some people who haven't made exercise a regular part of their lives may find it hard to get started—or to keep going. Here are some tips from the American Heart Association.¹

• Choose an exercise that's fun for you. If you like the activity, you'll be more likely to stick with it.
10 minutes before work, another 10 minutes during lunch, and another 10 minutes after dinner. Save the 30-minute walk for a time when you feel less rushed and can enjoy the outdoors.


• Exercise with a friend or family member to keep up your motivation.



• Reward yourself regularly for sticking to your exercise commitment. Think of things that you enjoy, but usually don't treat yourself to: a massage, a makeover, a ball game, a night out at the theater, a special trip.



• If you backslide, don't give up. Everyone has days when it's tough to exercise. Just begin again, and remind yourself that lapses are only temporary.

Count the benefits

Think of exercise as a way to strengthen and condition your heart. After you've exercised regularly for awhile, you may be able to exert yourself longer with less fear of an angina attack. That's because as your heart and body fitness increase, your risk of heart disease and other chronic illnesses such as diabetes may decrease. In fact, one study has shown that an inactive lifestyle can be as harmful to the body as smoking.²

If, however, you feel angina pain during exercise, stop immediately rest, or take short-acting nitroglycerin if your doctor has ordered it for you. Talk to your doctor about whether you should adjust your exercise schedule to prevent future attacks. If you find that your angina is becoming more painful or begins after very little physical activity, see your doctor right away.

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Sources

1. American Heart Association. To Your Health: A Guide to Heart-Smart Living. 2001.

2. Erikssen G. "Physical fitness and changes in mortality: the survival of the fittest." Sports Medicine, 2001; Vol. 31. 571-576. PubMed