Benefits of Exercise for Patients with Coronary Heart Disease (CHD) Cardiovascular disease (CVD)is responsible for almost one in two of all deaths in the UK and it is the leading cause of premature death in both men (40%) and women(30%). The most common form of CVD is Coronary Heart Disease (CHD) which is second only to cancer (all types) in terms of mortality rates. The number of deaths from CHD in the UK is amongst the highest in the world and the most common results we see are Myocardial Infarction (commonly known as a heart attack) Cardiac Arrest and Angina pain. There are four main risk factors to CHD which are inactivity, high blood pressure, smoking and hyperlipidaemia (high blood fats). Other risk factors include obesity, diabetes, gender, family history, age, ethnic origin, stress and high fibrinogen levels (tendency of the blood to clot). Benefits of Exercise for Patients with Coronary Heart Disease (CHD) With these in mind, the benefits of regular exercise and being more physically active are; Increase in circulation Improvement in overall heart health, including increase in stroke volume and cardiac output Decreased blood pressure Decreased resting heart rate Increased lung function Improvement in blood lipid profile Less prone to fatigue Improvement in overall energy, stamina and endurance Increase in muscular endurance and metabolism efficiency Weight loss Increase in insulin sensitivity/improved diabetes control In addition exercise and physical activity also help; Improve confidence, mood and sense of well being Reduce anxiety and depression Improve return to work rates and leisure activities Improve health education both for the person also and their friends/families Increase compliance with lifestyle modifications Many Primary Care Trusts (PCT) have recognized the benefits of Cardiac Rehabilitation (CR) as an integral part of medical management and as a means of preventing or limiting the chances of further Cardiac Events. CR aims to restore and maintain optimum levels of physical, mental and psychological well-being after cardiac illness. The main aspects of CR are a combination of education, exercise and psychosocial support, which are delivered by a multiprofessional team consisting of doctors, nurses, dieticians, counselors, physiotherapists/occupational therapists psychologists and qualified exercise professionals. CR usually takes the form of four phases, of which Phases 3 and 4 are exercise based, either in a hospital or community based setting. Those who would benefit from CR include people who have had; Myocardial Infarction (MI) Cardiac Arrest (CA) Angioplasty Stable Angina Pectoris Coronary Artery Bypass Graft (CABG) Valve replacement Heart transplant Pacemaker or Defibrillator fitted Heart Failure (if deemed eligible) The types of exercise recommended are a mixture of walking, home exercises, gym or studio/circuit sessions and chair based classes. In addition gentle exercise, Tai Chi, Aquafit, Linedancing, Pilates or Yoga can be undertaken in many cases. All Cardiovascular exercise (CV) should be in three stages. For example for a one hour exercise session The Warm-up: The warm-up phase is done at the beginning of your workout and prepares your body for physical activity. This gradual increase in activity encourages active blood flow to the working muscles and allows the coronary arteries to dilate, ensuring enough blood supply gets to the heart itself. It increases heart and respiratory rate, increases the overall body tissue temperature and facilitates neural transmission for motor unit recruitment. The warm-up phase of your workout for CHD should last approximately 15 minutes. The Workout: This portion of the workout can last from 15-35 minutes depending on your goals and current fitness level. This is the core of your CV workout. At this point, you should be into your target heart rate zone, or if on certain medications, your Rate of Perceived Exertion (RPE). The Cool Down: This phase should also last 10 minutes and in essence is the opposite of the warm-up. This is an important phase of your CV workout and should not be overlooked. The cool down slowly decreases the workload of the CV system and allows a smooth and safe transition back to the lower work demand. Be sure to include plenty of stretching during your cool down phase.