Alex Simotas, MD

Hospital for Special Surgery
Board Certified Physiatrist
Specializing In Spine & Sports Medicine

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Cardiovascular Health

One of the key components to a healthy lifestyle is cardiovascular health. This article deals with some of the basics that everyone should know about cardiovascular risks, cardiovascular health and integrating a cardiovascular program into your lifestyle and why it is important.

Cardiovascular Risk Factors

There are many risk factors associated with poor cardiovascular health including coronary heart disease and stroke. The following are major contributors to the risk of cardiovascular related diseases: tobacco use, alcohol use, high blood pressure (hypertension), high cholesterol, obesity, physical inactivity and unhealthy diets.

You will not necessarily develop cardiovascular disease if you have one or more risk factors but the more factors you have, the greater the likelihood that you will develop cardiovascular problems, unless you take action to modify these factors and work to prevent them from compromising your heart health.

How Can I modify my risk of developing a cardiovascular problem?

Hypertension: Hypertension is the single biggest risk factor for stroke and also plays a significant role in heart attacks. It can be prevented and successfully treated but only if you have it diagnosed and stick to your recommended management plan.

Abnormal blood lipid levels: Abnormal lipid levels include high total cholesterol, high triglycerides, high low-density lipoprotein or low high-density lipoprotein (HDL) cholesterol. All of these will increase the risk of heart disease and stroke. Changing to a healthy diet, exercise, and medication can modify your blood lipid profile.

Tobacco Usage: Smoking or chewing tobacco increase the risks of cardiovascular disease.  The risk is an especially high risk if you started smoking when young, smoke heavily, or are a woman. Passive smoking is also a risk factor. Stopping tobacco use can reduce your risk significantly, no matter how long you have smoked.

Physical inactivity (or lack of exercise): Physical inactivity increases the risk of heart disease and stroke by 50%.  Obesity, which is related to physical inactivity, is a major risk for cardiovascular disease and predisposes you to diabetes.

Type 2 Diabetes: Type 2 Diabetes is a risk factor for coronary heart disease and stroke. Poorly regulated diabetes makes you at greater risk for cardiovascular disease at an earlier age than other people and it will be more devastating.

Poor Diet: A diet high in saturated fats increases the risk of heart disease and stroke. Proper diet and exercise are two of the major ways to increase your cardiovascular health. Proper diet and nutrition is covered in a separate article.

Below, we deal with exercise and its impact on cardiovascular health.

What is cardiovascular endurance?

Cardiovascular training involves exercises that utilize both our cardiovascular and respiratory systems. Activities that cause your heart to beat faster or cause you to breathe more rapidly are activities that improve your cardiovascular endurance. Cardiovascular training is often referred to simply as “cardio” or “aerobic” training and include exercises such as cycling, running, walking, and swimming.

Why is cardiovascular training important?

Improving your cardiovascular endurance through exercising causes your heart and your lungs to become stronger and more efficient. A trained athlete’s heart at rest will be required to beat fewer times per minute than an untrained individual’s. By requiring fewer beats per minute you are improving the efficiency of your heart and lungs and allowing the body to maintain health with less strain and difficulty.

How does cardiovascular exercise help your muscles?

Cardiovascular training will also help strengthen and improve large groups of muscles. This is important because muscles that perform under longer duration and distance will be strengthened. The “core” and spine muscles have a large proportion of muscle devoted to endurance function and improving cardiovascular endurance will help strengthen the spine.

How do I measure cardiovascular endurance?

Measuring the intensity of cardiovascular activities is an important way to assess both the effectiveness and the improvement of your program.

The American College of Sports Medicine (ACSM) recommends that individuals train between 64 – 94% of their maximal heart rate to improve health and endurance.

The following equation is used to determine individual maximal heart rate:

Maximal HR = 220 – age
Using the maximal heart rate an individual can determine his or heart ideal training range by multiplying maximal heart rate and target percentage.
Target HR (lower) = [maximal HR] x 0.64
Target HR (upper) = [maximal HR] x 0.94

For example, a 35 year-old individual with an estimated heart rate of 185 (220 – 35 = 185) would want to exercise with the range of 118 – 174 beats per minute.

How much exercise should I do?

An initial goal would be to exercise until you reach your target heart rate and maintain it at this level for 20 to 30 minutes a day three (3) times a week.

How do we measure our heart rate?

There are several methods for measuring your heart rate. Finding your pulse on your neck or on your wrist is an effective way to count your heart beats. After you find your pulse you can watch a clock for 15 seconds as you count the number of times that your heart beats. When you determine the number of beats in 15 seconds you can multiply this number by 4 to establish your heart rate, or beats per minute.

You can also purchase a heart rate monitor to wear while exercising to ensure that you are training within the target range. This is highly recommended. A heart monitor can be purchased at any sporting goods store. This will measure your heart rate and accurately calculate calorie expenditure.

Improving your cardiovascular health and endurance is a key aspect in developing your overall wellness and to maintaining your musculoskeletal health!