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British Heart Foundation
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Post stenting exercise

Hi,

I'm 74, have angina and exercise four times per week for up to a total of about 5.5 hours.

8 years ago I had one Angina episode, subsequent angioplasty and stemting.

Also I take RAMIPRIL and BISOPROLOL FUMARATE

My normal exercise routine involves, walking on treadmill, indoor rowing and cycling on static. I also do a little weights circuit. I also exercise using a Heart Rate Monitor.

My question is about the use of the Monitor in respect of what limits I should set the Monitor to bearing in mind the effects of my drug regime.

The formula of 220-age for maximum heart rate is way too high given the control of heart rate by the drugs!

So, bottom line is:

What should my absolute training heart rate be given the conditions outlined above!

Cheers,

Colin

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Hi Colin,

a few of us discussed this a while back, the thread of which can be found here,,,

healthunlocked.com/bhf/post...

The bottom 3rd of the thread deals with how the max exercising HR is (loosely) calculated. Basically, the 220 minus age is for people without heart issues. For people with them a % of between 65-80% is applied depending on what is wrong, fitness etc.

Bearing in mind I'm not a healthcare professional, based on what you've said I'd estimate it as follows:-

220-74 = 146

146 x 85% = 124bpm

You're doing all the right things and seem pretty fit but if you wanted to be on the safe side you could apply 80% to 146 = 117bpm, or even 75% which would be 110bpm.

Listen to your body and if you feel your estimated exercise HR figure is pushing it, ease back a bit, but somewhere between 110-120bpm max seems about right to me.

Hope that helps some.

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Hi Marc68,

Thanks very much for your swift, informative response.

What you have suggested makes eminent sense and I will start tomorrow based on an absolute max of 120 and Monitor at that for a couple of weeks to see how it goes. I will also take on board that I have no intention of running a Marathon (already done that) and am more likely robe interested in a bit of shark fishing!!

Thanks for help

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Hi Colin, you're more than welcome.

Most people don't use their HR when exercising but I find it a useful measurement. After that thread I spoke with my cardiologist and he said he was happy for me to exercise at 140bpm, which is roughly where the calc said it should be. I also had an exercise stress test which got me upto 148 with no problems at all.

As I say though, I'm just a patient who wanted to know my max exercising HR and the calc is simply based on research I and others have done. It's not an exact science and everyone is different so it's important to listen to what your body is telling you. I'm sure you'll find a suitable rate after a few sessions.

Good luck.

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Hi Colin,

I'm 70 and had a stent fitted 5 years ago after a heart attack.

I was very fit and used to exercise twice a week in the gym with my HR regularly going up to 170+ whilst running on the treadmill (I used to do high intensity interval training).

Post HA I was also put on Ramipril, plus statins, apsirin etc etc, but not a beta blocker because of a low resting HR.

After a few months I started suffering Tachycardia attacks, my pulse would suddenly go up to 170/180 whilst out for a gentle cardio walk! This was probably due to scar tissue forming on the heart and disrupting the normal electrical pathways around the heart muscle.

Anyway, I was put on Bisoprolol 1.25mg and this seemed to fix the problem, but it also dropped my resting HR to the mid 40's from about 55 (normal for me as I was very fit), but it also seemed to limit how fast my heart would beat.

At the gym I still work out and now cannot get my HR above 130 no matter what I do. I find the treadmill readings are unreliable as the chest strap bounces around and the readings are all over the place, but the cross trainer, bike and rower are less violent and give steady readings, but as much I try (sweat pouring off me) I can't post more than 130bpm.

I don't know if perhaps you have a similar experience, but beta blockers do tend to limit max HR whatever you do, which is I assume the way they reduce the stress on the heart.

Anyway, it doesn't seem to limit my normal life as I feel fine, my ejection fraction is 55-60% which I understand is normal, but I do think my stamina has been reduced.....but then I'm still here so I'm grateful.

Hope this info might help,

Regards,

Derek

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Thanks for this Derek, I’m 49 and had a HA last May. I’ve done no proper exercise since then because if truth be known... I’m a little worried of having another HA or other heart issues. But to hear how you exercise at 70 has inspired me to get on and start doing some myself. I didn’t go to the heart rehab course the hospital was offering post HA due to work etc but I’ll check out the links and comments others have mentioned here and hopefully try and build up some stamina without killing myself! :)

Regards

David

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Hi David,

the heart is a muscle and, like any other muscle, if you don't exercise it it becomes weak. Not exercising is much more likely to cause you further heart problems. It's unfortunate you didn't attend rehab as it's the best place to give you the confidence to exercise following a HA.

Get out walking to start with, and build the distance and speed up gradually.

Good luck.

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Hi David,

Regular exercise is supposed to be the most effective way of maintaining a healthy heart after a HA, better than any of the drugs, but like you, after my HA I was very wary of overdoing it.

The rehab class is great for building confidence, I'm sure you can still enroll and they will pass you on to a personal cardio trainer at the local gym on completion. After a year or so my confidence returned and now I carry on as before with my HA just a memory, but I do wear a HR monitor and just keep a check on my heart rate so I don't overdo it, and of course diet, weight, stress (my problem), are kept under control.

Sharing your experiences at the cardio rehab also helped me a lot, it makes you realise you're not alone and there's lots of support.

Good luck!

Derek

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Hi Rugby nut,

That's another thing we have in common.....Rugby!!!! The only game worth playing!!! Ha!

Really love that game and played until I was 46!

However, thanks for the information as I will listen to anything which encourages me to keep exercising. As I have difficulty running, I now only use treadmill for walking and find it ok if a bit boring! Am going to really focus on my routines for a while and info akin to what you suggest makes sense although I fear that my targets will have to be much lower than yours!

Cheers,

Colin

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I feel your pain with getting bored walking on the treadmill. I listen to audiobooks while in the gym now (via Audible) and find that helps keep me going. Very satisfying to feel like I'm exercising my brain at the same time as my other muscles! :)

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Hi Colin,

At my gym they have machines with TV screens, or you can use an IPAD or smartphone, but yes, it can get boring.

Finding someone to exercise with helps as you can yack away and the time flies, esp if it's a fellow rugbynut!

I find the cross trainer good because it's low impact and works both upper and lower half of your body, same with the rower.

Try to keep stress levels low, a bit difficult at the moment as the six nations has started....

Looking for a grand slam!

Derek

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