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Maine Cyclist
Fitness and a Healthy Heart: Aren't They the Same? Dave Atwood's article about his personal experience with a heart event illustrates an important point about coronary artery disease: You can be fit and not heart healthy. We've all heard of people who have had similar events, including Maine's own Bill Pinkham and the even more high-profile James Fixx, who wrote The Complete Book of Running yet died of a heart attack while exercising. How can such things happen to such fit people? Many factors contribute to our overall heart health. Fitness is just one. Genetics, body mass index (BMI), diet, smoking and drinking habits, and general lifestyle all can play a role. While I have known 50-year-old weekend warriors with advanced clogging of their heart arteries ready to have "the big one," I have also found 19-year-old elite college runners with life-threatening electrical abnormalities of their heart. Do you have risk factors for a similar event? You might. Half the people with heart artery clogging don't know it until they have a heart event or heart attack-that's 50% of those with coronary artery disease! The fundamental difficulty with heart artery clogging is that a given artery can become up to 85% clogged with plaques and you may not have any symptoms! That means that you have an artery that allows only 15% of the blood through. You can still do many things and not notice some of the subtle signs that Dave so accurately pointed out in his article. These include having shortness of breath while using your arms for carrying or walking up stairs; your performance decreasing in your workouts; chest pressure, tightness, "heart burn," or indigestion that's new; your arm or jaw aching with exertion; your getting easily fatigued; and even your having difficulty with routine household chores, such as carrying a laundry basket up two flights of stairs (no, this isn't an excuse not to help out at home!). The final clogging of that last 15% usually occurs when a plaque ruptures (breaks off) and goes downstream, where it plugs up the artery completely. This can happen while exercising, when the heart gets a workout. But it can also occur at other times. What are the risk factors for heart artery clogging? They include:
If you have three or more of the above risk factors, you should be screened for heart artery clogging. A screening will include a physician visit, appropriate blood tests, an EKG, and probably an exercise treadmill test. Regular exercise can reduce your risk of heart artery clogging by reducing blood pressure, lowering weight and cholesterol, and improving blood sugar control. It should be a part of everyone's healthful lifestyle. But some caution is needed. Check with your doctor before starting an exercise program, especially if you have risk factors. Attention to your heart health may prevent you from being one of those people -- fit or not -- who finds out the hard way about having coronary artery disease. Dr Curtis is Medical Director of HealthWORKS, Occupational & Sports Medicine; Member, American College of Sports Medicine; and Medical Consultant, Bicycle Coalition of Maine.
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