The Healthy Heart: Preventing, detecting, and treating coronary artery disease

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• Table of Contents
• An excerpt from this report

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If you follow the news about heart disease, it’s easy to be overwhelmed or confused about what puts you at risk and how to protect yourself. This report helps you identify the risk factors you can control, which range from medical conditions such as high blood pressure to lifestyle choices such as an unhealthy diet or lack of exercise. This report also describes the latest improvements in diagnosis and treatment so that you are aware of your options and can talk with your doctor about them.

Prepared by the editors of Harvard Health Publications in consultation with Thomas H. Lee, M.D., Professor of Medicine, Harvard Medical School, and Harvey B. Simon, M.D., Associate Professor of Medicine, Harvard Medical School. 67 pages. (updated: 2007)

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Here's an Excerpt from this Coronary Artery Disease Special Health Report

Physical activity is one of the best ways to protect yourself against heart disease. What kind of exercise is best, and how much should you do? This is where people often become confused, perhaps understandably, as the recommendations sometimes vary. In 1995, the Centers for Disease Control and Prevention and the American College of Sports Medicine recommended 30 minutes or more of moderate physical activity most (preferably all) days of the week; in 2002, the Institute of Medicine upped the ante by recommending 60 minutes of moderate activity every day for people who need to lose weight. In 2007, the American Heart Association set the bar even higher, recommending 60 to 90 minutes of moderate-intensity physical activity preferably every day, for people who need to lose weight or keep weight off.

So what should you do? Aim for 30 minutes or more of moderate activity per day as a good initial goal (and if you want to build up from there, all the better). Aerobic exercise, which employs large muscle groups in a rhythmic, repetitive fashion for prolonged periods of time, has long been considered the best type of exercise for the heart—but flexibility exercises (those that stretch muscles) and resistance exercises (which strengthen them) are also good. What follows is a quick guide to what constitutes a reasonable prescription for exercise.

Get started. If you aren’t doing much physically, then mild exercise a few times a week will cut your heart disease risk in half. Even mild activity, like walking at a reasonable pace a few times a week, can make a big difference in the health of your blood vessels. Raising your heart rate and dilating arteries modestly can help to lower your blood pressure and prevent atherosclerosis. Start with 20- to 30-minute walks three days a week, then build up to 30 minutes or more nearly every day. If you feel chest pressure, lightheadedness, or marked shortness of breath, see your doctor right away. If not, get back out there!

Keep going. Daily exercise will help you to burn more calories, and that will have a whole range of beneficial health effects.

Pump up the volume. If you can do mild or moderate physical activities daily, start doing short bursts of more intense activity. You can walk five miles every day at the same slow clip, and you will burn plenty of calories, but you won’t really make your cardiovascular system much healthier. Research has shown that short bursts of intense activity—30 to 60 seconds of really pushing yourself—takes the health of your blood vessels to a new level. If you walk for exercise, for instance, increase your pace, try a slow jog, or try walking in a pool (the water provides resistance, making you work harder). This type of moderate physical stress on the arteries helps to keep them younger.

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