Appendix A:
To Do before Exercising Smarter

BY CATHERINE W. BRITELL, MD

Starting a new exercise program is exciting. You can look forward to getting stronger, having more energy, and looking better. However, if you have some uncertainty about your cardiovascular health, you may have well-founded concerns about whether it’s safe to begin a new exercise program.

If you have had symptoms such as chest pain or irregular heart rhythm, or had a heart attack or a coronary artery stent or bypass, you must consult with your doctor before trying any new vigorous exercises. In addition, consulting with your physician is especially important if you:

        •  Are over forty

        •  Have diabetes

        •  Smoke

        •  Have high blood pressure (above 140 systolic and/or 90 diastolic)

        •  Have high LDL cholesterol and triglycerides and low HDL cholesterol

        •  Have a waist circumference greater than 32 inches in women and 37 inches in men

        •  Are sedentary

The good news is that both high-intensity interval training and eccentric strengthening have been shown to be excellent ways for individuals with cardiac problems to become healthier and stronger, if started and monitored carefully in a supervised program of cardiac rehabilitation.

The bottom line: see your doctor before starting any kind of new exercise program, and bring along a concise outline of the exercises you plan to do. If you have cardiovascular risk factors, a cardiology consultation and possible cardiac stress testing are the best way to ensure your getting into your new exercise program safely. If you have cardiac abnormalities, high-intensity interval training and eccentric strengthening may be very effective, provided they are done with appropriate cardiac monitoring on recommendation of your cardiologist.