EMBARGOED FOR RELEASE: 4 p.m. EDT Monday June 30, 1997
NR 97- 4568 (Circ.Physical Act.)
CONTACT:
AHA News Media Relations
(214) 706-1173 or 706-1396
American Heart Association science advisory:
Physicians should promote physical activity as fervently As they do smoking cessation and blood pressure control
DALLAS, July 1 - Physicians might better serve their patients if they promoted physical activity as fervently as they do smoking cessation and controlling blood cholesterol levels, according to a science advisory published today in Circulation, a journal of the American Heart Association.
The "how-to" statement delineates the fundamentals involved in creating a physical activity regimen that is beneficial for the general population and for those with heart disease or those who have had a heart attack. For people who are overweight, physical activity is vitally important because obesity is caused mainly by taking in too many calories and not getting enough exercise. Obese people are at higher than normal risk for heart attack.
"The purpose of this statement is to encourage people to be more active," says Gerald Fletcher, M.D., professor of medicine and cardiovascular disease, Mayo Clinic, Jacksonville, Fla., lead author of the statement. "Rather than just say, 'exercise,' we want to give people the nuts and bolts and specifics of how they can increase their physical fitness.
"You can tell anybody to exercise for 30 to 60 minutes--it can mean anything. We want programs to have specifics on how long, how much and how often and which muscle groups to target." Fletcher said that in addition to adopting guidelines for physical activity, physicians must make a concerted effort to endorse the benefits of physical activity to their patients and to encourage patients to do activities they enjoy. People are more likely to stick with a program if they enjoy what they're doing. Activities need to be convenient and fit in people's busy schedules.
"If physicians are talking to their patients about controlling cholesterol and the dangers of cigarette smoking, they should also stress the importance of exercise," he said. "When a physician tells you to stop smoking, there is some authority behind that. It should be the same way with getting people to be more active."
According to Fletcher, physical activity regimens should begin in early school years and continue throughout life. Schools should specifically designate physical education programs to provide aerobic activities for children at early ages.
Programs should include recreational sports and also implement selected types of resistance exercises with use of free weights or exercise machines. In addition, there should be support for an active lifestyle for children at home. According to guidelines, physical activity should include bicycling (stationary or routine), walking, jogging, swimming and other aerobic recreational-leisure sports.
This activity should be done for at least 30-60 minutes four to six times weekly or 30 minutes on most days of the week. The frequency, duration and intensity of the activity should be individualized personal goals and satisfaction.
"I tell people to exercise up to the point of near breathlessness -- where it's difficult to talk to the person next to you," Fletcher said. "People usually don't want to go that far. They don't want to get tired, but you have to do that in order to get something out of your exercise session." Resistive exercises using free weights or standard machines should be done two to three times weekly. Fletcher recommends these exercises include 8-10 different exercise sets and 10-15 repetitions per set (arms, shoulders, chest, trunk, back, hips, legs) performed at a moderate intensity. If using free weights, a total of 15-30 pounds is adequate. Resistive exercises tend to complement aerobic exercise and make a more comprehensive physical activity regimen. A more important result is development of muscle tone and strengthening of body muscles as adults age over time. Physicians need to make sure that their patients who have had a heart attack or heart surgery don't overdo their physical activity and that they get the support they need. "The point we're trying to get across is that when these patients start to feel better, and are feeling well enough to exercise, we want to take it slowly and build them up to a point where they want to do more," he said. "These patients need confidence and, by exercising with others and maintaining a steady rate of exercise, they can gain this confidence." For such individuals, walking is recommended as the mode of exercise unless the individual can attend supervised classes where other physical activities can be provided. According to the statement, begin with 15-20 minutes of walking and continue with a gradual increase of 5 minutes each week. The emphasis of physical activity within the first two weeks after a heart attack or coronary bypass surgery should be to offset the effects of bed rest or periods of inactivity that preceded the heart attack or surgery. Although this activity is well tolerated and safe, certain precautions are recommended such as awareness of chest discomfort, dizziness and shortness of breath.
An exercise test is often performed after the individual is stable (as early as 2 to 6 weeks after the heart attack or surgery) and such testing is essential prior to beginning a physical activity program.
For conditioning purposes, people should exercise their larger muscles at least 30 minutes (preceded by warm-up and followed by cool down), at least three to four times weekly. The prescription for physical activity in patients with heart disease should be based on the exercise test. Supervised group sessions are recommended initially to ensure the patient is tolerating the program, confirm that progress is occurring and provide medical supervision to those participants who are at a higher risk for heart attack. Home programs without supervision can be used for those who have a lower exercise risk, and who are motivated and understand the basic principles of training.
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Media advisory: Dr. Fletcher's office telephone number is (904) 953-7278. (Please do not publish telephone numbers.)
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