WHAT I’VE LEARNED…….ABOUT EXERCISE

heartstethatscopeThe other day my patient Mr. T, was having his physical and I asked him about his health habits.  I asked about his exercise, and he explained to me that he did aerobic exercise three days a week for 30 minutes, doing treadmill and cross-training and bicycling, and he said something to me that was very accurate and worth sharing:  “I know I could do more, but I am exercising to make sure my heart can ‘take it’ if something were to happen.  Perhaps it won’t prevent me from having a heart attack, but it’s enough to help me get extra flow to my heart so that my heart will make it through.”

You know…. I 100% agree with Mr. T, and this is something I have found over the past 25 years of practice; that exercise keeps you in shape, helps prevent heart issues ‘to a degree’, but more importantly, makes your heart more capable of withstanding the stresses to your body under extreme health issues or in the event of a heart attack.

This is exemplified by the results I see on treadmill testing in the office.  I still do the standard Bruce Protocol treadmill testing as I find it very predictive of a person’s heart-health.  The old-fashioned treadmill test have been around since the late 60’s, and is often considered too ‘old-fashioned’ or not ‘sexy’ as a medical test, and thus it is overlooked.  But, the treadmill is an excellent test for prognosing….predicting the future.  A person’s performance on the treadmill has two facets:  Diagnosis & Prognosis.

Diagnosis:    The diagnostic side of the treadmill is good, but imperfect.  Based on the changes in the blood pressure, heart rate, and EKG (electrical tracing) we can see that the heart is healthy or that there are issues with blood flow in one of the coronary arteries (one of the three major arteries to the heart muscle).  Sometimes the tracing changes are very specific and very diagnostic, but this type of test is not as accurate as say a Nuclear Stress Test done by the cardiologist, which uses  both the treadmill portion to look exercise capacity and at the heart function and imaging based on blood flow of radioactive tracer dye in the heart.  That said, it is much simpler and much less expensive.

Prognosis:  The prognostic side of the treadmill is it’s strong suit.  Based on comparing data of the patient’s specific performance with millions of others who did the same test protocol, one can generally predict their longevity based on the heart’s capacity, heart rate response to exercise and  to recovery.  I’ve performed thousands of treadmill tests and have seen that exercise capacity has a direct correlation with patient survival through stressful events, even survival in the setting of the rare heart attack occurring despite reassuring diagnostic features of a treadmill test.

So, although exercise is not a perfect preventive approach to one’s health, it ranks as #1 on my list of the 8 Keys to health (See the entire list in my book:   THE KEYS  )

Do:  Exercise at least 3 days per week

Do:  Exercise for at least 30 minutes.

Do:  Perform aerobic exercise (bike, run/treadmill, fast walk, swim, cross-train)

Do:  Get you heart-rate up during exercise and get a ‘sweat’ going.