Exercise and Heart Disease

StethoscopeDear Chris,

Am I more prone to heart attacks and other coronary issues if I exercise when I’m older?

Steve in Toronto

Dear Steve,

Engaging in cardio-respiratory or aerobic exercise will actually reduce your chances of having a heart attack or developing coronary Heart Disease. This type of exercise will make your heart stronger, help reduce your resting blood pressure, and keep your circulatory system running smoothly. However, this type of exercise does come with some risks and reducing those risks depends a great deal on your overall health. The risk of developing coronary heart disease or having a heart attack does increase with age. However, the conditions that lead to coronary heart disease are more related to lifestyle factors (and sometimes genetic ones) than to the aging process itself. Often people don’t know they have coronary heart disease until they suffer a heart attack, especially if they had not exhibited symptoms like angina before or were never diagnosed with it.

That being said, there is a small risk of suffering a heart attack while exercising. There are definitely things you should keep in mind when starting an exercise program at any age but especially as you get older. If you’ve been sedentary or are overweight, chances are your heart is not as healthy as it should be. You should first see your doctor and let him or her know that you want to be more active. He or she may order a stress test to determine what your target heart rate should be. If your doctor has some concerns, he or she may give you a safe target heart range within which to exercise. Otherwise, there is a formula you can use to calculate it (see below). Either way, proceed slowly.

If you haven’t been active, don’t try to make up for lost time and jump into your program full force. Unless your doctor has given you other instructions, warm up for 5-10 minutes first at the low end of your target heart rate zone (see below). As your body warms up and your heart gets ready to exercise at a stronger intensity, you can gradually bring your heart rate up higher. Much of what you determine to be a safe exercise intensity zone will depend on your own health as well as medications you may be taking (some medications can affect your heart rate).

There are different ways to calculate your target heart rate zone. Here’s a common and conservative way, ideal for beginners:

  • First, subtract your age from 220. This will give you your age-predicted maximum heart rate. For example, if you are 65, then your age-predicted maximum heart rate is 155 beats per minute (220-65).
  • The lower limit is generally 60% of this number. For a 65-year old, this would be 93 beats per minute (155 times 60%). Your warm-up heart rate should not exceed this lower limit, and in any case should never exceed 100 beats per minute.
  • The upper limit is generally 80% of the age-predicted maximum heart rate — in this case, 124 beats per minute (155 times 80%). You should not work out above this rate.

Using a target heart rate zone is only one way of determining safe exercise intensity levels. There are other measures such as the Talk Test and the Rate of Perceived Exertion. When I am working with clients, I always ask them to say a sentence out loud (and I don’t mean two words!). During the warm-up, they should easily be able to speak conversationally. They should also describe their exercise intensity level as “light” on the Rate of Perceived Exertion scale (I’ll talk more about this in an upcoming column). Once they are past their warm-up and are exercising more intensely, they should need to take a breath at the end of a sentence but they should not be feeling uncomfortable (nauseous, dizzy, lightheaded). Similarly, they should describe their level of exertion as “somewhat hard” or “hard” on the Rate of Perceived Exertion scale.

The most important thing to remember is to give your heart a chance to get stronger gradually. It needs time to adjust to this new level of demand you have placed upon it. But with patience and perseverance, you will reap the benefits of a strong and healthy heart.

To your health


Information on stayingstrong.ca should not be used for diagnosis, nor should it be considered a replacement for consultation with a healthcare professional. If you have questions or concerns about your health, please contact your healthcare provider.

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