Jumping back into an exercise routine is never easy, but is it dangerous? Providence cardiologist James Beckerman, M.D., weighs in on matters of the heart in this Q & A.
Q: I haven’t exercised in ages and I’m overweight. I want to start exercising again. Should I be concerned about my heart?
A: Exercise is generally safe for the vast majority of people. If you have significant, undiagnosed heart disease and want to participate in a rigorous exercise plan right out of the gate, that might not be the best plan. But most everyone should be able to get involved with exercise, such as a walking program using light weights.
If you are concerned about risk factors for heart disease, consult a doctor. Older individuals may also want to check with their primary care physician before beginning a rigorous exercise plan, even if they don’t have risk factors.
Q: What are the common risk factors I should be aware of?
A: Smoking and diabetes, both Type 1 and Type 2, are at the top of the list. High blood pressure, family history of heart disease and abnormal cholesterol are also risk factors to consider.
Q: What happens to the heart when someone starts exercising again?
A: Just because you haven’t been exercising doesn’t mean you are at risk. Hearts are designed to pump 100,000 times a day for the rest of our lives. Our Paleo ancestors were used to the idea of getting their heart rate up and doing lots of activity. From an evolutionary standpoint, the heart is made to be active.
If you haven’t been as active, your heart might not be as efficient. That doesn’t mean it doesn’t pump well – it’ more about your heart’s ability to accelerate or decelerate. A heart that has been accustomed to exercise pumps more efficiently because it can achieve a higher heart rate, which means the heart is delivering more oxygen to tissues and can recover more quickly as well.
Q: I’m so out of shape and exercise is hard. How do I keep going?
A: Fatigue is not a bad thing. It’s the body’s way of telling you, in an uncomfortable way, that you need to slow down. Training helps push your wall of fatigue. It’s incredible to see how quickly someone training for a 5K or a marathon changes that wall. That’s why it’s so exciting for me to help people train for a 5K.
Part of fitness is your heart’s ability to respond to exercise. With a little time and investment, you can make your heart healthier. You will see that in performance, endurance and enjoyment of physical activity.
Q: Will exercise do any good if I already have heart disease?
A: Even if you have heart disease, regular exercise will reduce the risk of heart attack or death. Studies suggest that even among people with heart disease, exercise reduces the risk of early death by 20 to 25 percent. Other studies indicate that people who are least fit are four times more likely to die of heart disease than the fittest people. Fitness, in this case, was measured by how far people could walk on a treadmill.
Exercise is the best medicine we can prescribe. Being less fit is the biggest factor for heart disease, more than diabetes or family history. Eighty percent of the global risk of heart disease is lifestyle. You have the opportunity to reduce the risk of heart disease without any side effects. Exercise also reduces the risk of cancers and other chronic diseases.
The exercise that works best for you may be different for others. I believe all of us are athletes — some of us just don’t know it yet.
If you have questions about starting an exercise plan, contact a Providence provider.
Answers have been edited for length and clarity.
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