Pumping Marvellous

How important is excercise to you as a Heart Failure patient?

Before we talk to you about this really important article it is important that you get the go ahead from a clinician before you start any exercise and especially marathon running!!

People with heart failure who are also depressed may benefit from regular, moderate exercise, a new study suggests. Researchers found patients who exercised an hour and a half to two hours per week had slightly lower depression scores, which in turn were tied to a reduced risk of re-hospitalisations and deaths related to heart problems.

Still, the effects of exercise were “modest,” researchers said. “We know that in people who have existing heart disease, including heart failure, that if they have depression on top of it, it tends to make matters worse,” said Kenneth Freedland, a psychiatrist from Washington University School of Medicine in St. Louis who wasn’t involved in the new study.

“Exercise seems to be helpful, but by itself, it’s probably not a sufficient treatment for clinical depression in somebody with heart failure,”  Still, Freeland added, “anything that can make a dent in (depression) is a good thing.”

The new findings are based on a secondary analysis of a study looking at the effects of exercise on long-term health risks in people with heart failure, which occurs when the heart can’t pump enough blood to the rest of the body.

Close to six million people in the U.S. and 1 million people in the UK have heart failure. Moderate exercise is generally considered safe in people with heart failure, as long as they have been first cleared by their doctor.

In 2003 through 2007, researchers randomly assigned 2,300 people with heart failure to a supervised and at-home exercise program or to their usual treatment. They asked participants about depression symptoms at the start of the study and tracked both those symptoms and hospitalizations and deaths over time.

Participants in the exercise group had three 30-minute workout sessions per week for three months, then were given a treadmill or stationary bike to continue exercising at home for another nine months.

About 28% of patients were clinically depressed at the start of the study, based on a questionnaire covering 21 different symptoms. Depression scores in general — and especially in people with a depression diagnosis — tended to drop with exercise. But the disparity between exercisers and non-exercisers was small, equal to participants scoring similarly on 20 out of 21 symptoms and exercisers getting a “mild” score on one symptom where the usual care group got a “moderate” or “severe” score.

“Most of the patients were not depressed,” said lead researcher James Blumenthal, a clinical psychologist at Duke University Medical Center in Durham. “To go from being not depressed to a little bit more not depressed may not be that clinically meaningful.”

A person’s heart rate, also known as their pulse, refers to how many times their heart beats per minute. Our heart rates vary tremendously, depending on the demands we make on our bodies – a person who is sleeping will have a much lower heart rate compared to when he/she is doing exercise.
There is a technical difference between heart rate and pulse, although they both should come up with the same number:

• Heart rate- how many times the heart beats in a unit of time, nearly always per minute. The number of contractions of the lower chambers of the heart (the ventricles).
• Pulse (pulse rate) – as the blood gushes through the artery from a heart beat, it creates a bulge in the artery. The rate at which the artery bulges can be measured by touching it with your fingers, as on the wrist or neck.

So what is your resting Heart Rate

For a human aged 18 or more years, a normal resting heart rate can be anything between 60 and 100 beats per minute. Usually the healthier or fitter you are, the lower your rate. A competitive athlete may have a resting heart rate as low as 40 beats per minute.
Champion cyclist, Lance Armstrong has had a resting heart rate of about 32 beats per minute (bpm). Fellow cyclist Miguel Indurain once had a resting heart rate of 29 bpm.
According to the NHS the following are ideal normal pulse rates at rest, in bpm (beats per minute):

• Newborn baby – 120 to 160
• Baby aged from 1 to 12 months – 80 to 140
• Baby/toddler aged from 1 to 2 years – 80 to 130
• Toddler/young child aged 2 to 6 years – 75 to 120
• Child aged 7 to 12 years – 75 to 110
• Adult aged 18+ years – 60 to 100
• Adult athlete – 40 to 60

Measuring your own Heart Rate

Although their are numerous areas you can measure your Heart Rate these are the two most common -

• The wrist (the radial artery) – place the palm of your hand facing upward. Place two fingers on the thumb side of your wrist gently, you will sense your pulse beating there. Either count them for up to one minute, or thirty seconds and then multiply by two. Counting for 15 seconds and then multiplying by four is less accurate. It is also possible to test the pulse by touching the other side of the wrist, where the ulnar artery is.
• The neck (the carotid artery) – place the index and third fingers on the neck, next to your windpipe. When you feel your pulse, either count for the whole sixty seconds, or do it in a 30 or 15 second spell and multiply by two or four.

Numerous studies have found that walking offers tremendous cardiac benefits. It helps people improve their fitness levels and endurance capacity, and it burns calories to aid in weight loss. Walking can lower your blood pressure, improve your cholesterol levels and your body’s ability to handle glucose or sugar, and reduce your risk of diabetes.

Aim to do 30 minutes of moderate-intensity exercise at least five days a week, or 20 minutes of vigorous activity three times a week. Moderate-intensity exercise is seen as the equivalent of a brisk walk, as if you have someplace to go, while vigorous exercise is even faster walking. If you’re starting an exercise program, just avoid doing vigorous activity until you’ve been exercising for a few months. The same goes for people with existing heart problems: Unless you have your doctor’s  or nurses okay, stick with moderate-intensity regimes.

If 30 minutes sounds too daunting at first, you can get the same benefits by doing three 10-minute bouts each day. For instance, maybe you walk your dog for 10 minutes in the morning, take a 10-minute stroll at lunch, and walk for another 10 minutes after dinner.

Strength Training for Heart Health

Strength training will not replace aerobic exercise but compliments and  boosts muscular strength and endurance; helps your body handle blood sugars; reduces blood pressure; and increases lean body mass, which can help prevent weight gain. Because you’re losing lean body mass, which burns more calories than fat, you gain weight. However, when you do strength training, you maintain lean body mass and prevent weight gain.

Do strength training for your entire body twice a week, completing one set of eight to 12 repetitions for each muscle group. As you progress, increase to two or three sets. If you’re not sure where to start, work with a certified personal trainer for one or two sessions,  or buy an instructional DVD or book. If the Gym is a local council run gym they are certified to help you make decisions, even better apply to join a Healthy Lifetsyle Team monitored event.

Pair your strength training and aerobic activities with a heart-friendly diet and you’ll be well on your way to building a stronger, healthier heart.

Always consult your Doctor or Heart Failure Nurse if you are doing strength training and if you have been sedentary for awhile, check with your Doctor or Heart Failure Nurse before starting any exercise regime.

Look to your legs Heart Failure Patients

Doctors tend to treat  heart muscles when the organ reels under an attack, overlooking the condition of the legs, which could provide vital clues in treating the condition, new research says.

A University of Leeds research team has, for the first time, shown that  leg muscle dysfunction is related to the severity of symptoms in heart failure patients, the Journal of Applied Physiology reports.

“Many chronic heart failure patients complain of leg fatigue during  exercise and this can prevent them from being active,” says Harry Rossiter, of the Faculty of Biological Sciences at the university.

“Our study shows that by warming up properly, patients can improve the oxygenation and performance of their leg muscles, which is beneficial in promoting exercise tolerance,” he adds.

In a series of experiments with chronic heart failure patients, the research team measured responses of the heart, lungs and leg muscles following a moderate exercise warm-up, according to a statement from the university.

Using a near-infrared laser to measure the oxygenation of the leg muscles, they found that warm-up exercise increased the activity of skeletal muscle enzymes that control energy production.

However, this adaptation was less in patients with the most severe symptoms, showing that the heart failure condition had a negative impact on the normal function of the leg muscles.

“When your muscles don’t use oxygen well, it causes an uncomfortable burning sensation during activity,” says Klaus Witte, cardiologist in the team.

“The effect of a warm up is to direct oxygen to the places that are going to need it, and make the muscles ready to use it when you start exercising,” Witte adds.

“Our main message is that exercise is safe and beneficial in patients with heart failure. By warming up the leg muscles properly, the exercise can be more comfortable and sustained for longer – affording great benefits for these patients,” Rossiter says.

Healthy Heart

Healthy Habits for people who want to help their Heart get healthy

Some very basic tips for Heart Health

Don’t smoke – Male smokers had an 86% higher risk of heart failure compared to those who had never smoked. Women smokers had a 109% higher risk.

Maintain a Healthy Weight –  Men who were obese were 75% more likely to develop heart failure, and women were 106% more likely. Being overweight increased the risk of heart failure by 15% in men and 21% in women.

Exercise – . Men who regularly engaged in moderate physical activity, like walking, had a 21% lower risk of heart failure; women who did the same had a 13% lower risk. Higher levels of exercise and physical activity reduced this risk even more, by 33% in men and 36% in women.

Eat vegetables –  Men and women who ate vegetables three to six times per week had a 26% and 27%, respectively, lower risk of heart failure than those who ate vegetables less than once per week.

Exercise is very important to Heart Failure patients and this information has been provided by one of our experts Beth Baron. Beth is the Cardiac Practioner for the Burnley Healthy Lifestyle Team. She rehabilitates Heart Failure patients as well as other people with Coronary Vascular Disease.

Why Should I Be Active?

Activity may improve the functioning of your heart, by reducing the workload and enabling it to beat more efficiently. Regular activity will also help to keep the big muscles in your legs working efficiently taking some pressure off your heart and helping you with your balance.  Keeping active will help improve your symptoms and could help to prevent your condition from getting worse.  Exercise can also help improve the quality of your sleep, improve your mood and feel more positive about the future

So How Do I Start?

Before starting an exercise programme, or if you want to increase or change the type of exercise you do, talk to your doctor or nurse to make sure you are not putting too much strain on your heart too quickly. They will also be able to advise you which activities to avoid. They may be able to refer you to your local cardiac rehabilitation programme or healthy lifestyles team where they will be able to advise you on a suitable programme for low-intensity training.

Choose an activity that you enjoy, as you will be more likely to do it regularly. Exercising with a friend also helps, as you will be able to encourage each other. It is important to understand what you can do, if you didn’t go jogging before you had heart failure, you probably won’t be able to now you have heart failure.

Safety First!

Always warm up before doing any activity and always cool down afterwards.  This will make sure that your coronary arteries have the opportunity to open up to allow more blood to deliver essential oxygen to your heart muscle. If you don’t do this you are at risk of your heart beating irregularly which could be dangerous.  A qualified British Association of Cardiac Rehabilitation (BACR) instructor will be able to show you how to do this safely. If it is cold or windy outside, you should try and warm up before leaving the house. Try walking around for a couple of minutes as this will reduce the shock to your body when you go outside.

Walking is a good activity to start with. Try to walk every day by doing activities such as collecting the newspaper, or getting off the bus one stop earlier.

If you already walk and consider yourself physically active, try cycling or swimming – swimming is now considered to be safe for people with heart failure
provided that you condition is stable and you are not excessively breathless during gentle activity or breathless at rest. ALWAYS start slowly and gradually
increase the distance or intensity of the activity as your strength/fitness improves.

A good rule of thumb is that you should still be able to talk while you are exercising. If you are not able to talk, you are probably overdoing it. Stop exercising at once if you experience shortness of breath, dizziness, chest pain, nausea or a cold sweat. If the symptoms persist, contact your doctor or nurse.

Try not to exercise straight after a large meal, or when you haven’t eaten for a long time. Plan to exercise 1-2 hours after a light meal.

Many people with heart failure worry that they will no longer be able to interact with their children or grandchildren by picking them up. Listen to the signals your body sends you. Activities that require holding your breath, bearing down or sudden bursts of energy are best avoided. If your grandchildren are no longer as light
as babies it may be more sensible for you to sit with them on your lap.

If you are inactive, you are more likely to have a heart attack than someone who is active. Being active provides long term benefits for your heart health and general health. It helps control your weight, reduce blood pressure and cholesterol and improve your mental health – helping you to look and feel great.

Studies suggest that being physically active in middle age can increase your life expectancy by two years, the same benefit as giving up smoking.

Your heart is a muscle and needs exercise to help it keep fit so that it can pump blood efficiently around your body.

It’s never to late to start

Everyone can benefit from getting physical – whatever your age, size or physical condition. Just remember that you are never too old or too unfit to start doing
something.

The good news is that inactive people that start to do moderate physical activity feel the biggest health benefits. Your health risks will decrease as soon as you start to do more!

Some Top Tips for Staying Healthy

Being active is great for keeping your heart healthy and, along with eating a healthy diet, can help you to manage your weight and it’s not just good for your heart – physical activity also makes you look and feel great.

Adults should aim to do at least 30 minutes of moderate activity on five days or more a week. If you’re struggling to stay motivated, try these top tips to stay active:

Small changes add up

If 30 minutes of physical activity all at once seems like a lot to start with, try doing several short bouts of activity throughout the day.

Remember the positives

You’ll soon feel the benefits when you become more active. You’ll feel fitter, have more energy, be more relaxed and have more confidence.

Keep it real

Set yourself realistic goals that are specific and achievable. For example, set a goal to walk for 30 minutes every day or to learn how to swim.

Make a diary date

Plan a time to do some activity that fits in with the rest of your day and try keeping a diary to help monitor your progress and success. If you miss a day, don’t worry – just make sure that you start again the next day.

Keep on your toes!

Remember, everyday activities count so look for opportunities to be active during the day. For example, use the stairs instead of the escalators, walk to the local
shop rather than taking the car and do some stretches when watching TV. Every little counts!

Have fun

Choose activities that you enjoy to help you achieve your goals and keep you motivated. Why not give ballroom dancing, tennis, trampolining, yoga or pilates a try?

Get a buddy

Involve friends and family to make activities more fun, sociable and enjoyable. Go jogging with a friend and support and motivate each other, take the children
swimming or join an exercise class.

Mix it up

Make a list of enjoyable activities, such as dancing, gardening and yoga and place them in a jar. Pick a different activity to do each week. By varying your activities, you are less likely to get bored and lose interest.

Use reminders

Prompt yourself to be more physically active by keeping reminders around the house. Put Post-it notes on the fridge or by the kettle, place your cycling helmet on
your dressing table or put your walking shoes near the door.

Check your progress

Use a pedometer to count your steps to show you how well you are doing. Walking is an ideal activity as it’s free and easy to do anywhere. You could walk your
children to school and back every day, take the dog for a walk or find a local park and go walking with a friend.

Reward yourself

Recognise when you achieve your activity goals. Think of things that you could reward yourself with, like a copy of your favourite magazine, a new pair of trainers or a massage.

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Carers 12 Days of Christmas Special – Day 10

Stay connected with the outside world, even if it’s just by phone or online. Don’t isolate yourself. Talk to friends about something other than your situation. Stay interested in what would be going on in your life if you weren’t carer. It’s still there and you’re still a part of it.

Carers 12 Days of Christmas Special – Day 5

Research over the last decade is clear: Carers who devote themselves to their loved ones to the exclusion of their own needs become ill. In a study of spousal carers (Schulz, et al, 1999), carers who experienced mental or emotional strain had a 63 percent higher risk of death than non carers and caregivers

Physical activity is proven to improve both mental and physical health. It tackles anxiety, depression and anger. It enhances your immune system and decreases the risk of developing diseases such as cancer and heart disease. It helps maintain a healthy weight. Becoming more active can lower your blood pressure by as much as 4 to 9 mm Hg. That’s the same reduction in blood pressure delivered by some antihypertensive medications.

Three 10-minute periods of activity are almost as beneficial to your overall fitness as one 30-minute session.

For each hour of regular exercise you get, you’ll gain about two hours of life expectancy, even if you don’t start until middle age. Moderate exercise, such as brisk walking, for as little as 30 minutes a day has the proven health benefits listed above as well as:

Improves self-image and energy levels
Improves muscle tone and muscle strength
Improves circulation, which reduces the risk of heart disease
Helps prevent bone loss
Promotes enthusiasm and optimism
Reduces coronary heart disease in women by 30–40 percent
Reduces risk of stroke by 20 percent in moderately active people and by 27 percent in highly active ones
Helps in the battle to quit smoking
Helps you fall asleep faster and sleep more soundly
It’s also a good idea to spend some time outdoors. Sunlight on your skin helps your body produce vitamin D, which brings many added health benefits.

Related articles

• Carers 12 Days of Christmas Special – Day 3 (pumpingmarvellous.com)
• High blood pressure – Lowering blood pressure reduce risk of stroke and heart disease (blood-pressure-monitoring.org)
• Keep an Eye on Heart Disease (everydayhealth.com)
• How Much Exercise Does Your Heart Need? (everydayhealth.com)

Healthy Hearts at Work

A study by the British Heart foundation (BHF) was carried out among 1,383 UK workers. The findings were somewhat concerning.

It was found that overall, 81% of UK office workers fail to get the recommended amount of exercise a week. Some 55% spend more than half their working day sitting or standing still, with 48% eating lunch at their desks.

The health of small business workforces need improving, especially those based in an office environment. Small firms cannot take these recent findings lightly. Simple measures can be put into place to improve the health of staff, which in turn will be beneficial for spirit, morale and attitude.

In addition, 35% of workers don’t want to be seen getting hot and sweaty in front of other colleagues which is one potential barrier to healthy staff.

Lisa Purcell, project manager for the BHF’s Health at Work Programme said:

“Embarrassment shouldn’t prevent people from being healthy at work. The payoffs from even simple changes like taking a walk at lunchtime are too great to ignore.”

“Swapping tea-break biscuits for fruit or getting the team together for a lunchtime kickaround in the car park can improve productivity, reduce staff turnover and mean fewer sick days.”