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For immediate release
April 12, 2006

EXERCISE BEFORE AND AFTER HEART DISEASE
Expert focuses on primary and secondary prevention at ACSM Summit

ORLANDO, Fla. – Exercise remains an essential strategy to help individuals stave off heart disease and help cardiac patients avoid a second episode.  In an address today at the American College of Sports Medicine (ACSM) 10th-annual Health & Fitness Summit & Exposition in Orlando, Steven J. Keteyian, Ph.D., FACSM focused on the important role exercise plays in the primary and secondary prevention of heart disease.

Primary prevention applies to individuals who are currently heart healthy; secondary prevention is relevant to those who have already experienced a cardiac problem.  Exercise as a prevention technique continues to gain recognition and endorsement, as heart disease is now known to be the leading cause of death for American men and women.

"We have enough science to tell us exercise is helpful both in the treatment of risk factors and in preventing a second heart problem," said Keteyian.  "Insurance companies are recognizing the benefits of exercise, and are broadening their scope of coverage.  Just recently, Medicare made sweeping changes by covering cardiac rehabilitation and heart procedures, such as angioplasties, transplants, and heart valve surgeries.  This disease can be effectively managed with relatively modest amounts of exercise, which is motivating insurance companies."

Physical inactivity is a major risk factor for heart disease.  Obesity is particularly dangerous.  Smoking, high blood pressure, cholesterol, diabetes and stress must also be managed well.  Among other factors, men who have a family history of heart disease are at increased risk.

Keteyian emphasized the goal of prevention is to stabilize the inner wall of the artery, preventing clots from forming and blockages from growing for as long a time as possible.  For primary prevention, exercise by itself is an intervention step before disease development leading to a cardiac event or the need for medication.  Incorporating activity into a prevention program will have a positive effect on diabetes management and weight maintenance (or loss), but it is a common misconception that exercise actually lowers bad cholesterol.
"By itself," said Keteyian, "regular exercise is not a panacea.  It is, however, along with proper dietary habits and not smoking, a key behavior that everyone should take seriously if they wish to positively influence the quality and length of their life."

For cardiac patients seeking secondary prevention, regular exercise improves exercise tolerance or fitness, increases the likelihood of survival, reduces symptoms, and improves mood.  It may also facilitate a speedier return to work and help smokers quit.

"Patients with heart problems need to know they can begin their rehabilitation soon after an event," said Keteyian.  "The sooner the better, before they resume their old lifestyle.  It's now appropriate to begin two or three weeks after heart surgery and about 10 days after a heart attack.  The old days of waiting six weeks and treating heart patients as if they are too fragile to move doesn't cut it.  A cardiac rehab program will show patients they can break a sweat and not have another event."

Still, special exercise considerations are appropriate for patients with heart disease.  Keteyian recommends a proper warm-up, lasting at least five minutes.  The session should focus initially on progressively increasing frequency and duration, then intensity, and should start with cardiorespiratory fitness, adding resistance training later.  Also, exercise should be appropriately timed with prescriptions, such as nitrates and beta-blockers, so that activity does not block absorption and occurs within a window of three to 10 hours after medication (based on prescription).

To influence all-cause mortality and halt disease progression, Keteyian said patients must expend more than 1,500 kcal/wk through exercise.  That's approximately 50 minutes of physical activity most days of the week.  Keteyian notes a five- to 10-percent reduction in body mass seems sufficient to reduce future risk.  Qualified health and fitness professionals should provide a step-by-step approach to developing a safe and effective exercise prescription.  This is important, says Keteyian, because professionals are likely to work with clients who are free of significant heart disease and trying to prevent it, have significant heart disease and don't know they have it, or know they have heart disease and are trying to recover from its burden.  An ACSM-certified trainer can help develop a specialized fitness regimen for cardiac patients.  To find a trainer in your area, visit ACSM's ProFinder at www.acsm.org.

ACSM's Health & Fitness Summit & Exposition is going on now at The Buena Vista Palace at Walt Disney World. For more information on the event, or to speak with staff in the on-site media office, please call 407-938-6156 (through Friday, April 14, 2006).

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 20,000 International, National and Regional members are dedicated to promoting and integrating scientific research, education and practical applications of sports medicine and exercise science to maintain and enhance physical performance, fitness, health and quality of life.

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ACSM would like to thank the following supporters of the 2006 Health & Fitness Summit & Expo: Amino Vital, Gatorade, The Centers for Disease Control and Prevention, Mars, New Lifestyles, PowerBar, Sport Beans, Lippincott Williams & Wilkins, 6th Dimension Devices, exel, NSF International, Suunto, Thera-Band, Viasys Healthcare, and Yamax.