The Role of Physical Activity in Promoting Heart Health

In an era marked by sedentary lifestyles, the importance of physical activity and exercise cannot be overstated, particularly when maintaining a healthy heart. As the leading cause of death worldwide, cardiovascular disease demands urgent attention. However, scientific research has consistently demonstrated the transformative power of regular physical activity and exercise in promoting heart health and overall quality of life. By understanding the profound impact of physical activity on cardiovascular health, we can unlock the key to preventing and treating heart diseases.

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The Link Between Physical Activity and Heart Health

Physical activity and exercise significantly impact cardiovascular risk factors and are crucial in maintaining heart health. Regular exercise can help lower blood pressure levels by improving the efficiency of the heart and blood vessels, maintaining a healthy weight, and managing stress. Exercise also positively influences cholesterol levels by increasing the levels of "good" high-density lipoprotein (HDL) cholesterol and reducing levels of "bad" low-density lipoprotein (LDL) cholesterol and triglycerides. Exercise also helps the body use insulin more effectively; improved insulin sensitivity prevents insulin resistance and the development of type 2 diabetes. (1)

Engaging in regular exercise not only reduces the risk of the cardiovascular risk factors described above but it promotes the overall health of the cardiovascular system. Exercise strengthens heart muscles, improves circulation, enhances the efficiency of oxygen and nutrient delivery to the body's peripheral tissues, and reduces systemic inflammation. (2)

Types of Physical Activity for Heart Health

Aerobic exercise, often called "cardio," is any physical activity that increases heart and respiratory rates for an extended period. It involves rhythmic and continuous movements of large muscle groups in the body and requires oxygen to produce energy. Walking, running, swimming, cycling, and dancing qualify as aerobic exercise. Regular participation in aerobic activity has been linked to reduced risk of CVD, improved mental health, weight management, and increased energy.

Strength training, also called resistance training or weightlifting, is a form of exercise that focuses on increasing muscle strength and endurance by using resistance or weights. Exercises targeting specific muscle groups use resistance from sources such as weights, resistance bands, or body weight. The benefits of strength training include increased muscle mass, improved bone density, enhanced joint stability, injury prevention, weight loss, and increased metabolism. 

Flexibility and stretching exercises involve movements that elongate and stretch the muscles, tendons, and connective tissues to improve the range of motion and flexibility of muscles and joints. Flexibility is important in maintaining proper posture, preventing injuries, and enhancing athletic performance. Stretching exercises can be classified as static or dynamic. Static stretching involves holding a stretch in a fixed position to lengthen and relax the targeted muscles. Dynamic stretching involves moving the joints and muscles through a full range of motion in a controlled manner to warm up the body, increase blood flow, and prepare the muscles for movement.  

Tai chi and qigong are forms of meditative exercise characterized by slow, flowing movements and deep breathing techniques. Tai chi and qigong promote flexibility, balance, strength, posture, and a focused state of mind. Evidence supports using both forms of meditative exercise in treating cardiovascular disease, including hypertension and heart failure.

It's important to remember that incorporating physical activity into daily routines is a great way to maintain a healthy lifestyle. This involves finding ways to be more active as you go about your regular routine, such as taking stairs instead of elevators, parking further away from your destination, walking or biking to work when possible, and taking active breaks during sedentary activities. Research shows that each increase of 1,000 steps taken daily is associated with a 22% lower risk of all-cause mortality, and each 500-step increment is linked to a 7% drop in cardiovascular-related deaths.

Guidelines for Physical Activity and Exercise

The American Heart Association (AHA) provides evidence-based guidelines for physical activity to promote cardiovascular health. 

Adults should get at least 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic activity weekly, preferably spread throughout the week. Alternatively, a combination of moderate and vigorous activity can be performed. Moderate-intensity exercise includes brisk walking, water aerobics, and biking less than ten miles per hour. Examples of high-intensity exercise include hiking uphill, running, and swimming laps. Adults should also add moderate- to high-intensity muscle-strengthening activity at least twice a week. (3)

Children 3-5 years old should be physically active and be given plenty of opportunities to move throughout the day. Kids 6-17 years old should get at least 60 minutes of moderate- to vigorous-intensity (primarily aerobic) physical activity. (3)

Although not explicitly listed in the AHA's exercise guidelines, they recommend incorporating flexibility and stretching exercises into an exercise routine to maximize health benefits. Yoga and pilates fall into this category of exercise. (4)

Other recommendations include spending less time sitting and gradually increasing the amount and intensity of exercise over time. The AHA notes that adults can benefit more from physical activity by being active for at least 300 minutes weekly. (3)

Individuals with chronic conditions or just getting started with an exercise routine should work with a qualified healthcare professional, such as a physical therapist or exercise specialist, to develop a safe and appropriate exercise plan that tailors activities to accommodate specific needs, limitations, and fitness levels.

Exercise and Specific Heart Conditions

Patients with heart conditions should consult a cardiologist or cardiac rehabilitation specialist to obtain medical clearance before starting an exercise program. Cardiac rehabilitation is a structured exercise and education program designed for individuals with heart conditions supervised by professionals specializing in cardiac care. Benefits of cardiac rehabilitation include improved cardiovascular fitness, reduced risk of cardiovascular events, and enhanced quality of life.

Strategies for Motivating and Sustaining Physical Activity

Motivating and sustaining physical activity can sometimes be a challenge. However, there are strategies you can employ to help you stay motivated and make exercise a consistent part of your life.

Set clear and achievable goals for yourself. Having specific goals provides you with a sense of direction and purpose. Track your progress with a fitness app, journal, or wearable tracker. Seeing your improvements and accomplishments provides a sense of satisfaction and boosts motivation.

Exercise doesn't need to be a chore; engage in activities that you enjoy! Experiment with different forms of exercise until you find ones you look forward to. When you enjoy what you're doing, it becomes easier to stay motivated and consistent. Variety in activity can prevent boredom and maintain motivation, so incorporating different types of exercises into your routine can help with this. 

Exercising with a friend, family member, or joining a group class can be more motivating than exercising alone. Having a social aspect to workouts can hold you accountable, provide support and encouragement, and make the experience more enjoyable.

Until it becomes a habit, treat physical activity as a priority by scheduling it into your calendar. Block out specific exercise times and commit to sticking to them. Incorporate exercise into your daily routine by starting with small steps and gradually increasing the duration and intensity of workouts.

It's normal to have occasional setbacks. On days you miss a workout or are less active, practice self-compassion and focus on making the next opportunity count. When motivation is low, remind yourself of the benefits of physical activity. Remembering your reasons to exercise can push you to complete your workout even when faced with emotional challenges.

The Role of Healthcare Professionals in Encouraging Physical Activity

Healthcare professionals play a crucial role in encouraging physical activity. They serve as educators, motivators, and guides for patients seeking to incorporate exercise into their daily routines. Healthcare providers provide valuable information on the numerous benefits of physical activity, exercise guidelines, and tailored recommendations to individual needs and goals. Furthermore, healthcare professionals can help patients in setting and meeting realistic goals that consider their fitness levels and medical history. They monitor progress and can provide guidance for exercise modifications as necessary. Healthcare providers are important in helping individuals embrace a physically active lifestyle by offering expertise, support, and ongoing advice.

Functional Medicine Labs to Monitor Heart Health

Functional medicine labs are valuable tools in diagnosing, managing, and monitoring heart diseases and their risk factors. Some of the most common labs ordered by functional medicine doctors for their patients with heart disease are described below.

Comprehensive Metabolic Panel (CMP)

A CMP is a routine panel often ordered as part of a routine health screening, but it can also be used in diagnosing and monitoring various cardiovascular conditions, including diabetes, hypertension, and kidney disease. 

Complete Blood Count (CBC)

A CBC includes multiple biomarkers that assess the qualities and quantity of red blood cells and platelets in circulation. A low or high concentration of red blood cells and platelets in circulation can contribute to cardiovascular symptoms and exacerbate heart disease.

Thyroid Panel

Thyroid dysfunction is associated with poorer cardiovascular outcomes, so using a comprehensive thyroid panel to rule out hypo- and hyperthyroidism is an important aspect of the diagnostic workup for patients with heart disease. 

Diabetes Panel

People with diabetes have an increased risk of heart disease. A diabetes panel measures multiple markers of glucose metabolism and insulin resistance. 

Lipid Panel

Atherosclerosis influenced by dyslipidemia is a primary contributor to the development of coronary artery disease, peripheral artery disease, and chronic kidney disease. An advanced lipid panel provides detailed information about the composition and number of lipid-carrying particles and cholesterol, providing a more accurate assessment of cardiovascular risk beyond a basic cholesterol screening.

Inflammation

High-sensitivity CRP (hs-CRP), homocysteine, Lp-PLA2, and myeloperoxidase are well-documented markers of cardiac-related inflammation associated with atherosclerosis and cardiovascular events.

Heart-Healthy Lifestyle Beyond Exercise

By adopting a well-rounded approach to heart health, individuals effectively reduce the risk of heart disease, promote cardiovascular well-being, and enhance overall health and quality of life. A holistic approach to preventing and managing heart disease recognizes that various interconnected factors influence heart health. In addition to regular exercise, integrative cardiology focuses on the underlying causes of disease by adopting a healthy lifestyle that includes a heart-healthy diet, good-quality sleep, and stress management.

A heart-healthy diet should be personalized to an individual's dietary preferences but is any dietary plan that implements an anti-inflammatory food-as-medicine approach to promote healthy blood pressure, cholesterol, and vascular function. The DASH and Mediterranean diets are commonly referenced as heart-healthy because they emphasize non-processed, multi-colored fruits and vegetables, whole grains, high-quality dairy, lean proteins, and unsaturated fats. 

Not getting enough good-quality sleep is associated with poorer dietary choices, weight gain, diabetes, systemic inflammation, and increased risk of stroke, heart attack, and death. Therefore, prioritizing good sleep habits is essential to promote heart health. Aim for 7-9 hours of sleep nightly. Maintain a consistent sleep schedule, going to bed and waking up at the same time each day. Practice relaxation techniques, limit caffeine and alcohol, and create a sleep-friendly environment to promote better sleep.  

People with positive mental health and low levels of chronic stress are more likely to have lower blood pressure, better blood sugar control, less inflammation, and lower cholesterol - all linked to a lower risk of developing heart disease. Practicing mindfulness-based stress reduction techniques, including meditation, deep breathing, talk therapy, and yoga, is critical to enhancing heart health and function. 

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Summary

Regular exercise plays a critical role in maintaining and promoting heart health. Engaging in physical activity not only improves cardiovascular fitness, but also reduces the risk of heart disease by modulating cardiovascular risk factors, reducing stress, improving mental health, and encouraging restful sleep. Following exercise guidelines for cardiovascular health, a well-rounded exercise routine should be tailored to individual needs, medical conditions, and fitness levels. With the guidance of healthcare professionals, adherence to an exercise routine should be prioritized in an integrative heart-focused treatment protocol.