Individuals with coronary artery disease should engage in endurance training to improve heart function and enhance blood supply to this vital organ. Brisk walking is considered an ideal sport for them.
Coronary artery disease (the blood vessels supplying the heart) occurs due to atheromatous plaques that narrow the vessel lumen, resulting in insufficient oxygen and nutrients for the heart muscle. Leading cardiologists worldwide assert that physical exercise is one of the effective non-pharmacological treatments for this condition.
Endurance training enhances the heart’s pumping function, improves the oxygen absorption of the heart muscle, and promotes more efficient oxygen usage. Additionally, endurance exercises stimulate the development of collateral circulation in the heart, improving blood supply to the heart muscle. Regular training will lower the overall heart rate and reduce the heart rate during exercise, allowing patients to increase their pain threshold while performing daily tasks.
Brisk walking and jogging help lower blood pressure in patients exhibiting signs of hypertension (grades 1 and 2) – a contributing factor to the progression of the disease. This activity relaxes and increases the elasticity of the blood vessels in the active muscles, reducing peripheral blood resistance and, as a result, lowering blood pressure. However, it is important to remember that it may take 3-4 months of regular exercise for blood pressure to start decreasing, and it may take 2-3 years of consistent training for blood pressure to return to normal levels.
Regular endurance training also effectively aids in weight loss, regulates blood lipid levels, such as reducing cholesterol and triglycerides, while increasing high-density lipoprotein (HDL) levels, decreasing atherosclerosis, and lowering the risk of myocardial infarction.
The training program should be personalized, depending on the severity of the disease, signs of circulatory failure, the degree of hypertension, and other factors. For patients with angina, it is crucial to determine the stage of the disease. Exercise should not be performed if there is unstable angina (pain occurring at rest), acute myocardial infarction, class 2-3 heart failure, or blood pressure exceeding 180/100 mmHg.
Before starting a training program, patients must have their exercise dosage determined through a standardized exercise test on a cycle ergometer (conducted in a hospital). The heart rate during walking or jogging should be lower than the level that causes chest pain, shortness of breath, or palpitations, specifically 10-12 beats per minute below that threshold. For example, if chest pain occurs at a heart rate of 125 beats per minute on the ergometer, then during exercise, the patient must control their pace to keep the heart rate below 110-115 beats per minute.
The effectiveness of the exercise depends significantly on the intensity of the activity. To increase the walking or jogging pace, patients should take nitroglycerin before exercising; the pain-relief effect of nitroglycerin lasts for 30 minutes, which is sufficient for a workout session.
Among endurance exercises, brisk walking is the most suitable method for coronary artery disease patients due to its low intensity and the ease of adjusting the exercise dosage. In the initial phase, for 8-12 weeks, patients should focus on brisk walking, and afterward, based on their health status, they can alternate between brisk walking and light jogging. The duration of training should be 20-30 minutes per session, 5-6 sessions per week; even a training session of about 20 minutes can significantly improve the overall health of patients.
If during exercise there are sensations of heaviness in the chest, palpitations, shortness of breath, fatigue, or dizziness, the patient should reduce the exercise intensity or stop. If symptoms of angina occur, the patient must stop exercising and immediately take nitroglycerin.
Patients can participate in organized group exercises or train at home following a personalized program. The program must be developed by rehabilitation exercise specialists in collaboration with the treating physician. If possible, it is advisable to consult with a sports medicine physician.
Dr. Dang Quoc Nam, Health & Life
