Exercise and Plaque and CAC Discussion - British Heart Fou...

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Exercise and Plaque and CAC Discussion

Bluehope81 profile image
19 Replies

Just some ideas about exercise, everyone is different.

I have written about this before in some of my posts.

1. If you exercise for extended periods above 150 for say more than an hour , everyone is different, so times vary, your heart will begin to emit small amounts of troponin, this means heart muscles cells are dying. Marathons are not good on the body, and deaths are always a concern on the London Marathons.

ncbi.nlm.nih.gov/pmc/articl...

Key point here, extreme fitness is harmful, but moderate exercise is great.

2. CAC build up in the arteries is accelerated in athletes, high blood pressure and fast heart rates accelerate the plaque growth process, but are also likely to create the tears that start the plaque process.

ahajournals.org/doi/10.1161....

3. Bodybuilders, those who do squats and similar manoeuvres, due to the shape and geometry of the heart, the pressure and the force concentrates at the bottom of the left ventricle, leading to left ventricular hypertrophy and then on to heart failure, same with Oarsmans.

4. Electrical impulses in the heart are generated from the sick nodes, at the top right and then conduct over the heart in a so called EM envelope, long term inflammation, and wear can affect the sick nodes, as well as not having the right minerals in the heart muscles, electrical impulse issues can also be idiopathic.

5. So what to do?

Exercise is good, it releases nitric oxide into your arteries which can repair the endothelial layer and stop plaque progression. The pumping and increasing of blood pressure is good for keeping the arteries flexible, not to mention all the other benefits of exercise.

I work out 4 to 5 times a week at the gym.

Cardio, have regular breaks, I do 40 minutes on the treadmill and keep my heart around 130 then have a 30 minute break.

then I do 30 minutes of cycling and keep my heart below 140,

then i have a break 20 minutes

and do 30 minutes of weights, use weight machines, and isolate muscles only so that the pressure is not concentrated in the left ventricle, allow 3 minutes break per rep.

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Bluehope81 profile image
Bluehope81
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19 Replies

Wow, that is bloody impressive and I envy you ,not in a bad way but a I want to do that again way.

Can I ask how old you are, what heart issue happened to you and how long ago it was, how fit were you before?

I'm 53, had a STEMI in Nov 23. I thought and it's a BIG I thought that for the past 15 years I had a healthy lifestyle ie

did weight training followed by cardio bike at least 4 times a week, no smoking, takeaway once a week ,red meat once a month, mainly vegetarian and pulses, moderate beer.

So I'm not sure anymore if any of it counted.

In cardio rehabilitation ( currently 2 days a week) I'm doing on the machines some pretty hefty sets for chest,shoulders,lats,legs,then rowing machine etc but at a controlled heart rate, before my HA I loved getting a good sweat and high heart rate .

I also get in 2 ( minimum) a week , 1 hour walks with some good challenging steep bits.

My cardio instructor said I can go back to using free weights but I feel unsure at the moment so will continue with isolation machines but ramp up the frequency (days).

Bluehope81 profile image
Bluehope81 in reply to

Will reply to you in PM

Those two articles are interesting and have given me plenty to think about.

We hear about moderation in bad food, moderation in drinking but yet overlook / fail to understand that moderation in excericse is also something to add to the list.

Blearyeyed profile image
Blearyeyed

That is an incredibly large amount.Everyone is different, of course, but for most people , especially for people post heart events, the amount you are doing wouldn't be classed as moderate but intensive even if you are keeping an eye on your heart rate.

Each individual needs regular, moderate exercise but over exertion, or physical stress, is not good for us even if we get a mental buzz from it.

It's good to work at keeping moderately active throughout the day after a heart event , or with a long term cardiac condition rather than going for the burn.

Working within the comfort zone and gradually building up what you do as exercises become easier is key to most people getting consistent, symptom free exercise and improving fitness in a stress free way with chronic health conditions or during recovery.

Although some short intervals of Cardio are beneficial, most physios suggest that cardio level heart rates should only be held for 2-5 minutes at a time rather than sustained throughout a workout.

Depending on age , previous fitness and abilities and other health issues most people benefit more from shorter low intensity, steady state activities. Weight training isn't always appropriate for all people and needs to be begun again with care.

Things like walking , moderate cycling , swimming or aqua exercises, well paced resistance or isometric exercises like pilates and some circuit training , gentle rowing (after any surgical procedures are fully healed), dancing , tai chi , QiGong, golf, watersports like boating , kayaking and paddle boarding are all effective activities done little and often.

And people also need to remember that coincidental exercise from physical activities count as much too, like housework, playing with children , your job, gardening or washing the car.

In fact , cleaning a shower cubicle, mopping the floor, changing the bedclothes, or washing a car can use as many calories and give you a workout equivalent to 40 minutes weight training or a 20 minutes spin class or 20 mins jogging.

Even half an hour of ironing and putting the clothes away is equivalent to 20 minutes of aqua aerobics.

It's this hidden exercise that you need to consider when factoring in when to fit in other exercise activities in your day especially if you want to Pace Yourself and get the balance of activity and rest right to help stay symptom and injury free but still keep physically fit.

Exercise should always be a joy rather than a chore. And as my lovely physio says , No Pain , No Gain is a myth ; and quite a harmful one.

Bluehope81 profile image
Bluehope81 in reply toBlearyeyed

I think the point about the "no pain , no gain is a myth" is a really salient point

BeHealthy2day profile image
BeHealthy2day

I have seen a few Cardiologists and they have told me (this is with a mild heart attack) not to go over 115 for a brisk walk at least 30 -40 minutes. Not to jog or do inclines that challenge your heart. Why? Because your heart will not take the pressure and if you feel breathless you have gone to far it can bring on Angina or another gwart attack. The walking over time aid to the very slow breaking down of plaque and strength weights etc can do the same. The strain on the heart is ok for non heart patients. The more you can keep to a Mediterranean diet less meat dairy no sugar the more your heart will thankyou. Apparently it can take 3 years to reduce plaque this is with consistency in diet and exercise. I read something similar on the Mayo Clinic. This is just information...but I am doing it and feel better ... I can see my Cardiologist every 9 months which motivates me to do better.

Bluehope81 profile image
Bluehope81 in reply toBeHealthy2day

Thanks for your reply, glad you are doing well and improving.

DWizza profile image
DWizza

Thank you so much for the info Bluehope, really interesting . I’m grateful to be back to running and training and like you , I find the moderation and enjoyment better than my competitive days in sport. I found one of the articles a bit non committal , generally the studies were not perfect and the outcomes in the marathon runners still out did all cause mortality etc.

“We would still advocate consideration of CAC testing in those with high PA/EEE who have intermediate coronary risk profiles, with plans to intensify risk factor modification and statin therapy in those with high CAC scores and consideration for stress testing in those with very high CAC scores, at least to assess for severe ischemia and malignant arrhythmias.11 However, as Lavie et al11, 20 recently explained, high levels of PA and CRF are extremely protective against CVD events and mortality, making it possible for individuals to perform high doses of running and exercise safely even with high CAC and "hearts of stone."

I’ll be sticking to my 5-10k goals ( run 3 times a week) , 2x vinyasa flow yoga a week , 4k walks and physical work round my farm . My weekly intensity minutes (150 moderate) can add up to 500-750 minutes a week with some high intensity in there as well. That’s plenty enough. I’m very mindful that I want my new pipes to work for a long time . Working , walking and running in the countryside is bloody fantastic. I have a treadmill for when I can’t get out in daylight, it’s pretty tough compared to outdoors . Did 7k on it last week , but grateful as the weather was shocking..

Bluehope81 profile image
Bluehope81 in reply toDWizza

Glad your back at it, I agree about walking in the countryside, I live in a lovely village with a number of walks around, can't wait till the ground firms up a little, it's nice to wonder around the countryside without seeing people all the time, really clears the head.

DWizza profile image
DWizza in reply toBluehope81

It’s bloody wet round here too! Lanes and fields underwater . My paddocks are just mud baths , shin deep around the stable yard and gates. The sun is out though , wind subsided, going to wellies on and walk the dog 👍🏻🤣👊🏻

Mitchum profile image
Mitchum

Good morning. I really don't think you should frighten people by basically saying that squats are dangerous! The squat is probably the single most important weight training movement, utilising multiple upper and lower body muscles!

Blearyeyed profile image
Blearyeyed in reply toMitchum

Squats do , however, need to be considered with care in a workout programme for people of different ages , abilities and health profiles and illnesses like the members of our forum before being used by people without supervision.Many people after a cardiac event are new to gym based exercise activity and do need to know the precautions and how to prevent injury from certain exercises by learning to do them the right way before doing them at home.

Mitchum profile image
Mitchum in reply toBlearyeyed

I accept that. All exercise needs careful consideration but, I am assuming the advice given for all ages/comorbidities and capabilities has been considered. My arguments cover cleared participants who know what they are doing. For those people squats are an important part of their regime.

Bluehope81 profile image
Bluehope81 in reply toMitchum

Not medical advice, opinions and suggestions only.

The fact that it engages all muscles at the same time is the exact reason why it spikes your blood pressure to such extremes and should be avoided.

The high blood pressures are amplified by the shape of the left ventricle (prolate ellipsoid) and focussed onto the tip, this over time creates the issue of either hypertrophy of the left ventricle, or dilated cardiomyopathy.

I lift weights myself, and I enjoy lifting weights, bicep curl is currently 40 and lat pull down is 85.

I mean the list of bodybuilders who have died young is extensive

physicalculturestudy.com/20...

Due to a mix of steroids and wear on their hearts.

By the way I don't suggest anyone does anything, it's just my own opinion, people can take away from it what they want.

Mitchum profile image
Mitchum in reply toBluehope81

I'm sorry but those deaths are almost exclusively the result of steroid use. If they had never used drugs they would nearly all be alive today. Wear on their hearts translates to "steroid" wear!

Caterham80 profile image
Caterham80

The Cardiologist in this YouTube video is suggesting the same as your research. youtube.com/watch?v=olg90Dq... Hope the link works.

KingChanterel profile image
KingChanterel

Thanks for the above, an interesting read.

I have CAD and had two stents autumn 2021 aged 49 (now coming up to 52), thankfully have not had a Heart Attack and the CAD was picked up before anything happened. Family history of Heart Disease.

Since then I walk regularly, average 5 times a week for 35/40 minutes a session, fast pace walking, just over 7mins a KM, average heart rate between 138/150 (not on beta blockers as they dropped my resting heart rate too much, sub 40). Little concerned this maybe be a bit too intense reading the above.

I did get a Peloton a month back, but in the process of returning that, as my competitive nature kicked in and I realised the work outs would be too intense as I have to beat myself!

On thing I did notice reading the article on the CAC build up, was the cholesterol levels were around 5.5, I would assume a lot of us on here have considerably lower than that, due to diet and statins and wonder how much that would change the affects of exercising at that level.

Bluehope81 profile image
Bluehope81 in reply toKingChanterel

Not medical advice , opinions and suggestions only.

I don't think you need to change your routine because of the above, just to be aware about things , and the only person who can definitively say is your cardiologist.

The post was to have a discussion and chat about exercise and I think it's achieved that.

Statins and other medications reduce inflammation in the body, as well as eating a healthy diet, would mean the blood flowing over the lesions , whilst your exercising wouldn't aggravate the plaquing process in the same way, it would be reduced, but by how much and what type of person would benefit, no studies have been published on the matter to my knowledge.

What can be useful to know is your % MPI score , Myocardial Perfusion Imaging, if you had a HA and only 10% of your heart muscles have been affected, generally you wouldn't have any restrictions, so we can't say all HA patients must keep their heart below x, for example.

When I first had my heart attack I was so keen to get back on my pre ha excericse routine which was heavily geared to weights, kettle bells and bike, I suppose you want to prove to something to yourself.I now think that was a bit daft of me.

I'm now keeping weights to 2 days a week each a 1 hour session with breaks and do 3 × 1 hour a week of walking, it's pretty uneven around where I live so I get plenty of challenge.

I prefer this as I get to enjoy being outside with my music, thoughts and watching the world.

My goal now is to keep active and strong but without hurting my body. I'm not bothered about gaining mass,or if biceps etc just good body strength.

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