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Bouncing backBounce Back After a Heart Attack
by Linda Wasmer Andrews

The American Heart Association says more than a million Americans will have a new or recurrent heart attack this year. Fortunately, experts agree that exercise offers a chance to help prevent heart problems and enjoy better health.

"Some of our cardiac rehab patients say their heart attack was the best thing that ever happened to them," says Dr. Joan Dorn, an assistant professor of preventive medicine at the University at Buffalo in New York. "They're exercising more and taking better care of themselves now than they ever did before."

Dorn is now following up on a landmark 1976 to 1979 study of heart patients enrolled in an exercise program. The study included more than 600 men who were recovering from a heart attack. Twenty years later, Dorn looked at the men's long-term survival and found that during the study, those who had enrolled in the exercise program and improved their physical fitness did, indeed, live longer.

First Things First

If you've had a heart attack, check with your physician before starting an exercise program. If there's a cardiac rehabilitation program in your area, ask your physician about a referral.

Warning Signs

Stop exercising until you've talked to your physician if any of these symptoms occurs:
Discomfort in the chest, arm, neck, or jaw during exercise.
Faintness or shortness of breath during exercise.
Discomfort in the bones and joints during or after exercise.

Dr. Dan Williams, an assistant professor of exercise and sport science at Oregon State University, recently studied the cardiac rehab program at his local hospital. After three months, Williams says, "participants had higher levels of 'good' HDL cholesterol, lower levels of 'bad' LDL cholesterol and triglycerides, and less severe insulin resistance [a condition that is often a precursor to heart disease]. Overall, they cut their risk of having a future heart attack in half.".

Ready, Set, Go!

Once your heart condition is stable, your physician or cardiac rehab specialist can help you set up an individualized exercise plan. Dr. Roy Shephard, professor emeritus of applied physiology at the University of Toronto, helped devise a typical "exercise prescription" that was published last year in the American Heart Association journal Circulation. Here's what he recommends:

  • Start by walking. As your physical condition improves, you can vary the workout with other forms of aerobic exercise, such as jogging, cycling, and lap swimming.

  • Build up gradually. You might want to start with 20 minutes of light aerobic exercise per day, three days per week. Over time, you might build up to as much as 60 minutes of fairly intense aerobic exercise per day, five days per week.

  • Add strength training. Typically, you might do one to three sets of weight exercises for each muscle group per day, two to three days per week. Choose a weight you can lift eight to 15 times per set before feeling fatigue. Stick to exercises that keep the arms below the level of the heart, because your blood pressure must be higher to get the blood to flow through your arms if they're above heart level.

  • Keep it noncompetitive. "There are a lot of Type A people with heart disease who just want to compete like gangbusters," says Dr. Paul Thompson, director of preventive cardiology at the Hartford Hospital in Connecticut. "They push themselves through discomfort, and that can be dangerous."

Linda Wasmer Andrews is a freelance health writer.

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