Media contact: Anna Jones
Being physically active is an important part of heart health, but how should one take care of their heart while playing sports or exercising?
For Heart Month, Irfan Asif, M.D., chair of the University of Alabama at Birmingham Department of Family and Community Medicine, offers tips for maintaining cardiac health while exercising and playing sports.
How can regular exercise strengthen the heart?
Regular exercise has many benefits, including building muscle endurance and strength. Exercising can help people reach and maintain a healthy weight, while improving overall cardiovascular health. Exercise can help modify or control many cardiovascular risk factors, including hypertension, diabetes and unhealthy cholesterol levels.
“There is an inverse relationship between regular exercise and heart disease,” said Asif, associate dean for Primary Care and Rural Health at UAB. “This includes a beneficial effect of lowering bad cholesterol and raising good cholesterol. Exercise also lowers inflammation in your body and reduces blood pressure, both of which have protective benefits for the heart.”
What are some of the most common cardiac concerns that athletes may face?
For athletes younger than 35, the chance of having heart problems is much lower than for those over 35. However, about one in 300 individuals has an underlying heart condition and is unaware of it. Some of these underlying conditions include hypertrophic cardiomyopathy, which is an enlarged heart, Wolff-Parkinson-White syndrome, an electrical problem within the heart, and arrhythmogenic right ventricular cardiomyopathy, where fat infiltrates the heart. Many of these conditions typically show up before the age of 35.
“We don’t know the exact mechanism that triggers problems with those conditions yet,” Asif said. “We are still trying to determine if exercising at high intensity causes a little problem to become a big problem, or if there is another factor, such as not getting enough oxygen. We still have a lot to learn about that.”
Asif says individuals over 35, and especially those over age 50, are at higher risk of coronary artery disease. Blockages in the heart often occur due to buildup in the arteries that occurs over time. That buildup might get worse with diabetes, high blood pressure or smoking.
What are some simple best practices to keep in mind for exercise?
Asif reminds people that regular exercise is important. Getting 150 minutes per week is a good goal, balancing between endurance training, such as running, biking or walking, and strength training to build muscle.
A study in the Journal of the American Medical Association showed that increasing moderate to vigorous physical activity by 10, 20 or 30 minutes per day was associated with a 6.9 percent, 13 percent or 16.9 percent decrease, respectively, in the number of adult deaths per year in the United States.
Are there any warning signs people should look for before, during or after exercise?
During exercise, people may experience light-headedness, shortness of breath or chest pain. Some of these symptoms might be concerning, according to Asif.
“Shortness of breath can be tough to quantify; but if you are getting unexpectedly short of breath, are in more pain than usual or if you pass out, you should go straight to a medical provider to be checked out,” he said.
If you already have a heart condition, what are certain types of exercise you should pursue or avoid?
For those who have a heart condition, Asif recommends working with their doctor to determine which forms of exercise are best for them.
“Your health care provider might do certain tests to determine which exercises are safe for you or which heart rate zones you might need to stay within, but the specifics are dependent on the type of disease,” Asif said.
We have heard a lot about heart conditions associated with COVID-19. What should athletes keep in mind if they have had COVID-19?
Although Asif says that most people who had a mild case of COVID-19 usually do not face cardiac issues, he recommends that those who experienced a more moderate to severe case get their heart checked by a doctor before resuming athletic activities.
“Most often with COVID-19, we have seen myocarditis, or inflammation of the heart, after infection,” he said. “In addition to COVID-19, it can occur after other viral infections, such as influenza, and can lead to heart trouble. The risk is highest in the short-term aftermath of an infection and diminishes over time.”
According to the cardiopulmonary guidelines for high school student-athletes during the pandemic, published by the National Federation of State High School Associations, after a moderate case of COVID-19, if athletes experience any initial cardiopulmonary symptoms such as chest pain or palpitations, they should be evaluated by a clinician.
“Cardiac testing is recommended for any athletes with cardiopulmonary symptoms during the acute phase of infection,” Asif said. “Carefully screening for those symptoms and conducting tests as needed can help get athletes back into competition safely.”
If you have questions about taking care of your heart while staying active, or are experiencing heart-related symptoms, visit uabmedicine.org to find a provider.