Sunday, October 24, 2010


Cardiologists are always advocating the importance of fitness and exercise, advising that these activities are good for the heart. In all aspects, yes. Sedentary lifestyle is a coronary risk factor. We want our patients to be active and exercise. Although that advice is true, we must learn to distinguish what benefits exercise confers on the senior citizens ( many of us, myself included are near that stage of our lives ).
Firstly, regular moderate exercise, as we advocate for all people, is about brisk walking, 15 Km a week, in divided portions. Basically, 5 Km of brisk walking ( or its equivalent ) daily, 3 times a week. For those seniors, who do not wish to measure and be exact, I always tell them, 3 times a week of walking, until you break out into a good sweat. For some of them, at 75 years, this is reasonable advice. If you do this, you should be able to contain your weight, or even lose some weight, and improve your fitness. It may reduce your cardiac risk profile, keep away obesity, diabetes and hypertension ( the 3 sisters of CAD ). That is all true, but it may not make your heart younger.
To get your heart younger, is that possible?
The 18th October on-line edition of Circulation carries an article by Dr Naoki Fujimoto of Texas, USA, who examined the issue of exercise and cardiac muscle stiffness and fitness. He studied 12 males above 65 years, to see if 12 months of intensive exercise can regress the stiffness of the heart. These senior citizens were asked to exercise 6 days a week. After 12 months, all their cardiac performance indices were measured, in particular the cardiac muscle stiffness factors and also the arterial stiffness factors. These were compared with 12 elite athletes above 65 years. These elite athletes had been training 6 days a week all their life and had been taking part in competitive sports. He found that that although the arterial stiffness factors improved, and the major blood vessels became less stiff, it made no difference to the cardiac stiffness. Meaning that once you age, if you have been seriously exercising all your life, your heart remain less stiff, for longer. If you have not been exercising vigorously all your life, intensive exercises at 65 years or more, only helps you to keep fit and relaxes your arteries, but not your heart. This is obvious, because as we age, the heart muscle loses its tensile strength gradually and the muscular fibers get replaced by collagen fibers and amyloid ( we call this aging ), and it slowly becomes stiff.
The researches are now studying if drugs can help to stop this change and slow down the replacement of muscle fibers with collagen fibers. Studies have shown that the cut off point seem to be when we are 45-65 years when the cardiac muscles begin to be replaced, and any attempt to improve and reverse it may have to be undertaken at or before 45 years. I have my doubts. I do not think that you can fight against aging. Maybe we can delay it for a while. All cells are program to die, given time.
So, we learn that we cannot fight against aging. When you exercise, do so in moderation, 3 times a week and break out a good sweat. Especially if you are 65 years or more.
Keep fit, keep healthy and enjoy your age.

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