Snowstorms and Heart Disease

If you are a heart patient you might be concerned about how the cold weather affects your heart.  The body constricts blood flow to the skin to conserve heat, which also raises blood pressure. Many experience angina when active in cold weather.

Advice for how to manage angina related to cold includes:

• Do a warm up indoors to dilate the blood vessels and get heart rate slightly elevated before outdoor exertion
• Create a zone of warmer air to breath by using a scarf, mask or parka
• Avoid large meals and alcohol before exerting outdoors. Blood flow gets diverted and doesn’t go to the heart or exercising muscles instead it works to digest the food.
• Discuss using nitroglycerine before activity with your healthcare practitioner. Using the nitro to dilate the vessels prior to cold air exposure is a method used by some.

Snow Shoveling for Heart Patients

• Warm up, do some light exertion to dilate the blood vessels and get the heart rate slightly elevated before really “digging out”

• Dress appropriately in layers, when you feel warm take layers off. Preventing overheating from being overdressed is as  important as dressing for the cold. Your heart  works harder to cool your body down. Sweating excessively will lead to being cold later.

• Do not eat a large meal or smoke prior to shoveling, these divert the blood flow away from the heart and exercising muscles.

• Push the snow don’t lift if  you can.

• Exhale on Exertion.  Breath out when pushing or lifting, don’t hold your breath!!!! Holding breath increases blood pressure even further than the cold and exercise already has.

• Switch sides keep alternating the shovel in left and right hand. The constant twist to one side produces muscle injury and can be hard to distinguish between muscles and heart. Muscle pain can be reproduced with touch or movement, whereas heart pain cannot be reproduced by touch.

• Take breaks, listen to your body don’t over do it. The body constricts blood flow to the skin to conserve heat, which also raises blood pressure.

• Stay fit enough to shovel snow. If you don’t exercise regularly you are not strong enough to shovel wet heavy snow. The cardiovascular demands are even more due to excessive cold temperatures. Train for snow shoveling by performing aerobic exercise and resistance training.

• If you have symptoms STOP

Dealing with Raynauds in the cold weather

Raynaud’s occurs when the fingers and/or toes come into contact with cold. Beta blockers medications actually can aggravate Raynaud’s by leading to increased blood vessel spasm. This class of drugs, used to treat high blood pressure and heart disease, includes metoprolol (Lopressor, Toprol XL), nadolol (Corgard) and propranolol (Inderal, Innopran XL). It is important to cover your feet and hands before they get cold with warm gloves and socks. Make sure they are not too tight allow for circulation. Prevent the symptoms by creating a barrier between your skin and the cold. Even if you are only going out for a short while keep your fingers covered and wear warm foot protection. Frostbite occurs much quicker in persons with Raynaud’s.

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Atrial Fibrillation is more common in Winter

The likelihood of being admitted to hospital or dying with atrial fibrillation, a life-threatening chaotic heartbeat common among the elderly, increases dramatically during winter months. Atrial Fibrillation is common in persons with heart disease. Be alert for symptoms of irregular heart rhythm, increased shortness of breath, increased fatigue. Additional factors contributing to the winter connection to atrial fibrillation  may include drinking too much alcohol which leads to high blood pressure, heart failure, and possibly even stroke due to the  atrial fibrillation.

http://www.hearthealthywomen.org/am-i-at-risk/am-i-at-risk/hfother2.html

http://www.nhlbi.nih.gov/health/health-topics/topics/raynaud/

Winter Exercise for Heart Patients

Winter is upon us. It is cold, blustery, snowy, rainy, grey outside. This makes it very hard to be motivated to go outdoors and walk. Keep in mind it is very important to go outdoors and get approximately 10 minutes of natural light every day. This gives you Vitamin D. It is beneficial in preventing seasonal effective disorder. Interestingly seasonal effective disorder peaks in February. So there is a cumulative effect of getting natural light. Depression sets in and then people stop exercising entirely. I would always hear my heart patients say they will begin their home exercise when the weather improves. Uhg….your health should not be dependent upon the weather!

 

Do you feel better after you exercise? I believe when we go outdoors for a walk, run, bike ride, etc. it is more beneficial than exercising indoors.  I feel the best after outdoor exercise.  Not only does the exercise kick in your metabolism, but the bodies need to warm itself, then cool itself due to the exercise can only help the metabolism to increase. If your body temperature regulation system never gets the opportunity to kick in, it slows down and becomes less effective. Again kind of the principle use it or lose it.

A few winter exercise tips, yes I am sure you have heard them before, but here goes.

• Layer your clothing, start off cool, and when you get warm peel off layers before you overheat. Often winter exercise fatigue is related to being overdressed and the body is working extra hard to cool itself.
• Wear good shoes or boots- maintain traction, keep feet warm and dry
• Drink extra water — winter dry air leads to dehydration occurring more quickly
• Carry your nitro with you, just in case
• Walk with ski poles for extra intensity, better stability and posture

On really nasty weather days, have a back up plan. Indoor exercise that day, do weights, yoga, calisthenics, stretching, or take a drop in class at your local gym. Sign up for the gym or an exercise class for the worst weather months. Get out and walk the mall, hit the pool

If you get angina in the cold weather,  start your exercise by doing a warm up while indoors, do 5 or 10 minutes of activity that brings your heart rate up and dilates your vessels. Then when you go outdoors wear a parka, scarf or keep mouth covered. Maintain good posture. Engage your arms and legs…really think about pumping that blood throughout all your muscles.

I don’t recommend that heart patients use snow shoveling as their exercise.

You should exercise to stay fit enough to perform snow shoveling. That is why many heart attacks occur while shoveling. Many are not fit enough to perform this activity. The energy demands can be equivalent to running a marathon. If you are fit enough to run a marathon, then ok go ahead and shovel. The other thing is you can’t count on enough snow to go out and shovel every day…nice try with that one…doesn’t work.

Facts about cold weather and heart disease

Cold temperatures cause arteries to tighten, restricting blood flow and reducing the oxygen supply to the heart, all of which can set the stage for a heart attack.

In cold weather, there is more oxygen demand by the heart because it is working harder to do the work and maintain body heat.

Research suggests that the early-morning rise in blood pressure, or “a.m. surge,” that occurs in most people may dramatically increase the risk of having a heart attack or stroke. In the winter, people tend to exert themselves or do yard work in the morning because it gets dark earlier.

 

 

Winter effects on your heart

If you are a heart patient you might be concerned about how the cold weather affects your heart.  The body constricts blood flow to the skin to conserve heat, which also raises blood pressure. Many experience angina when active in cold weather.

Advice for how to manage angina related to cold includes:

• Do a warm up indoors to dilate the blood vessels and get heart rate slightly elevated before outdoor exertion
• Create a zone of warmer air to breath by using a scarf, mask or parka
• Discuss using nitroglycerine before activity with your healthcare practitioner. Using the nitro to dilate the vessels prior to cold air exposure is a method used by some.
• Avoid large meals and alcohol before exerting outdoors. Blood flow gets diverted and doesn’t go to the heart or exercising muscles instead it works to digest the food.

Snow Shoveling for Heart Patients

• Warm up, do some light exertion to dilate the blood vessels and get the heart rate slightly elevated before really “digging out”
• Dress appropriately in layers, when you feel warm take layers off. Preventing overheating from being overdressed is as  important as dressing for the cold. Your heart  works harder to cool your body down. Sweating excessively will lead to being cold later.
• Do not eat a large meal or smoke prior to shoveling, these divert the blood flow away from the heart and exercising muscles.
• Push the snow don’t lift if  you can.
• Exhale on Exertion.  Breath out when pushing or lifting, don’t hold your breath!!!! Holding breath increases blood pressure even further than the cold and exercise already has.
• Switch sides keep alternating the shovel in left and right hand. The constant twist to one side produces muscle injury and can be hard to distinguish between muscles and heart. Muscle pain can reproduced with touch or movement, where as heart pain cannot be set of by touch.
• Take breaks, listen to your body don’t over do it. The body constricts blood flow to the skin to conserve heat, which also raises blood pressure.
• Stay fit enough to shovel snow. If you don’t exercise regularly you are not strong enough to shovel wet heavy snow. The cardiovascular demands are even more due to excessive cold temperatures. Train for snow shoveling by performing aerobic exercise and resistance training.
• If you have symptoms STOP

Dealing with Raynauds in the cold weather

Raynaud’s occurs when the fingers and/or toes come into contact with cold. Beta blockers medications actually can aggravate Raynaud’s by leading to increased blood vessel spasm. This class of drugs, used to treat high blood pressure and heart disease, includes metoprolol (Lopressor, Toprol XL), nadolol (Corgard) and propranolol (Inderal, Innopran XL). It is important to cover your feet and hands before they get cold with warm gloves and socks. Make sure they are not too tight allow for circulation. Prevent the symptoms by creating a barrier between your skin and the cold. Even if you are only going out for a short while keep your fingers covered and wear warm foot protection. Frostbite occurs much quicker in persons with Raynaud’s.

.

Atrial Fibrillation is more common in Winter

The likelihood of being admitted to hospital or dying with atrial fibrillation, a life-threatening chaotic heartbeat common among the elderly, increases dramatically during winter months. Atrial Fibrillation is common in persons with heart disease. Be alert for symptoms of irregular heart rhythm, increased shortness of breath, increased fatigue. Additional factors contributing to the winter connection to atrial fibrillation  may include drinking too much alcohol which leads to high blood pressure, heart failure, and possibly even stroke due to the  atrial fibrillation.

http://www.hearthealthywomen.org/am-i-at-risk/am-i-at-risk/hfother2.html

http://www.nhlbi.nih.gov/health/health-topics/topics/raynaud/

Get More Out of Your Walk

 Walking, seems like a no brainer right? We don’t really think about it we just do it as it is natural. There are things you can do  to get improve benefits of walking. By focusing on style and posture you can improve muscle strength and tone, improve balance, correct postural issues and burn more calories.

Engage your arms!

Make a loose fist, consciously swing your arms, bringing your fist up to the approximate level of your breast bone, and then back to the outside of the hip. Pretend you are trying to move your arms against a force to engage the muscles even more when you walk.

Notice the posture of President Bush  – Shoulders back, arms active, stomach in,  head forward. Now compare to the gentleman next to him. Who do you think is getting more from their walk?

 Forward head, not engaging arms or stomach, rounded shoulders.

I show this to make you think about your posture while on a treadmill. Fast walkers on a treadmill who hang on to the bar often have a sway back posture. Slow walkers often lean way forward – I call it the pushing the lawnmower posture. While on the treadmill, try to either not hold on and swing your arms, or hold on with only one arm.  This will help you to have a better posture. When you hold on to the rails the entire time, your upper body is stiff and doesn’t move naturally as it does with your regular walking.

Also don’t look down the whole time this leads to forward head or thoracic kyphosis postures. Try to look 15-20 feet ahead of you. Hold your head high. Try to keep your chin parallel to the floor.  Squeeze those shoulder blades together and down…this is the military posture or the busty look, tall and proud.

Some people are so stiff with walking, add a little wiggle to your walk allow your shoulders and hips to move naturally, this is very good for your spine. Being stiff and rigid isn’t helpful. Often after open heart surgery people are very stiff in the shoulders and neck. Again swinging the arms helps this.

Tighten your stomach muscles. These support your back, they provide you with core strength. If the belly sags forward it places more stress on your lumbar spine. Tuck your pelvis under your torso.

If your have back issues or balance issues I recommend walking with ski poles. They help you to stand taller, force you to engage your arms with the walk, and you burn more calories on your walk.

Compared to regular walking, ski walking  involves applying force to the poles with each stride. Walking with ski poles uses more of their entire body (with greater intensity) and receive fitness building stimulation not present in normal walking for the chest, lats, triceps, biceps, shoulder, abdominals, spinal and other core muscles. This can produce up to a 46% increase in energy consumption compared to walking without poles. It also has been demonstrated to increase upper body muscle endurance by 38% in just twelve weeks.

This extra muscle involvement may lead to enhancements over ordinary walking at equal paces such as:

• increased overall strength and endurance in the core muscles and the entire upper body
• significant increases in heart rate at a given pace
• increasing vascular pathways and oxygen delivery efficiency
• greater ease in climbing hills
• burning more calories than in plain walking
• improved balance and stability with use of the poles
• significant un-weighting of hip, knee and ankle joints
• provides density preserving stress to bones

What about walking with weights? 

If you want to walk with weights don’t use more than 1-2 lbs in your hands. Heavier weights tend to stress the neck and spine and are not recommended. Again don’t just hold the weights pump those arms, swing up to breast bone and back to hip. You engage the arms, you burn more calories.

Healthy Vacations

Vacations can be challenging to maintain a healthy lifestyle.

 To maintain a healthy lifestyle it takes a little extra planning. My family just returned from travelling across the country from Michigan to Idaho. This involved a lot of driving 12 hours a day. It was tempting to stop for fast food, or eat out, but we chose to adhere to our healthy lifestyle.

Breaking up travel with exercise is helpful.

Next time you make travel plans be sure to include exercise to break up the doldrums of long car rides.  We found paths to walk, mountains to hike, swimming and white water rafting  to keep our activity levels up and not just sit all day. Yellowstone National park was amazing, but it shocked me how many people had to sit to watch Old Faithful, or could not walk the board walks to the most amazing sites such as Grand Prismatic Springs. We chose to hike 2000 feet up and hiked Avalanche Trail one day. That is not a trail for those unfit, as brings you from from 8580 ft to 10580ft in elevation. Good cardiovascular health is important.    

Eating healthy while on vacation takes some planning. 

While on vacation our plan was to maintain a healthy eating plan and save money. We decided there isn’t anything wrong with Peanut butter and Jelly on whole wheat bread. It is a good protein source for big adventures, carbs for quick energy and low in saturated fat.  Bags of cut vegetables are easy to buy at grocery stores instead of fast food stops. Fruit is plentiful, bags of apples travel well, grapes washed and ready to eat can make the time pass. We made a game to see who could  peel grapes the fastest. Snacks include granola bars, pita bread and hummus, cherries. Instead of soda water bottles were easily refilled en route, and the occasional bottled milk provided satiation and calcium. Not to say we didn’t eat out but it sure made the night with pizza feel like a treat and extra special. Often in working in cardiac rehabilitation I would have long haul truckers who had heart attacks and felt challenged to eat healthy. Truck stops are often just a few yards away from a town which always holds a grocery. Hit the fresh food aisle instead of the truck stops while traveling.