Tag Archives: heart failure

Heart Failure and the Importance of Staying Active, even in the Winter Months

Young trainer helping senior woman in aqua aerobics. Senior retired woman staying fit by aqua aerobics in swimming pool. Happy old woman stretching in swimming pool with young trainer.

When thinking of things that are bad for your health, sitting isn’t often the first thing that comes to mind. However, inactivity or sitting for extended periods of time can be harmful to your health. It is especially harmful to those with heart failure. But when many feel cooped up during these winter months, how can you stay as active? Karena A. Sauser, DNP ARNP, from the Cardiology Department at Medical Associates shares more on the importance of staying active and tips to do it safely in the winter months.

For a patient with heart failure, difficulty breathing and fatigue resulting in diminished exercise tolerance are among the main factors that contribute to decreased social and physical functionality and quality of life. Exercise is a safe, non-pharmacological intervention in stable patients with heart failure. Along with medical therapy, exercise has positive effects on both morbidity and quality of life. Remember to speak with your healthcare provider before starting any form of exercise.

Some patients with heart failure may qualify for cardiac rehab. During cardiac rehab, exercise occurs under supervision with monitoring of blood pressure, heart rate, and heart rhythm. The added responsibility of showing up for appointments gives cardiac rehab patients more motivation to exercise. Cardiac Rehab Programs are offered in the following regional locations: Mercy-Dubuque, Maquoketa, Independence, Anamosa, and Manchester in Iowa; Galena in Illinois; and Darlington, Dodgeville, Boscobel, Lancaster, and Prairie Du Chien in Wisconsin.

However, if your provider tells you it is okay, it is also acceptable to exercise on your own. Just remember to start slow and gradually increase the length and intensity of your workout. You can start with 5-10 minutes/day at a slow pace and increase time and speed as you get stronger. An ideal goal for patients with mild to moderate heart failure is to exercise at least 150 minutes per week (30 minutes 5 days/week or 20-25 minutes daily). It is best to pick activities that you enjoy and are low-impact, such as walking, biking, or swimming. It is important to have a five minute warm-up/stretching period and five minute cool-down/stretching period. Avoid abruptly stopping exercise or immediately sitting or laying down after exercise to prevent dizziness or lightheadedness. It is also important to exercise year-round, even during the bitter cold of winter. If fitness centers are not an option or do not fit into your budget, there are many other heated places to exercise as the weather turns cold. You can always walk in churches, shopping malls, bigger “boxy” stores (like Wal-mart), or at the Mystique ice arena on the upper deck.

When in doubt, remember to follow these tips to exercise safely with heart failure:

  • Avoid exercises that require or encourage holding your breath.
  • Wait at least one hour after eating to exercise.
  • Avoid exercises or actions that require short bursts of energy (interval training).
  • Exercise when you have the most energy. For most heart failure patients, this is in the morning.
  • Think about exercising with a friend or family member. This can make it more enjoyable and social. It also keeps you more accountable/committed.
  • You should be able to talk while you exercise. If not, then you are probably exercising too hard and need to slow down.
  • The day after exercise, you may feel more tired. It is important to balance activity and rest.
  • Avoid exercising in extreme weather conditions. Find safe spaces to exercise that are between 40 and 80 degrees Fahrenheit and under 80% humidity.
  • Avoid exercise when you are not feeling well, have a fever, or your heart failure symptoms are not controlled.

One of the most important ways people with heart failure can maintain their sense of well-being is to stay active. The impact of movement, even leisurely movement, can be profound. Remember to speak with your healthcare provider before starting any form of exercise. Window shopping the mall aisles with a friend, roaming your local museum or art gallery, or stretching and doing some light exercises throughout your daily tasks at home are a few great ways to stay active during the cold months. It all helps burn calories, increase your energy, maintain muscle tone, as well as improve your mental well-being, especially as you age.

 

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Karena A. Sauser, DNP ARNP
Department of Cardiology
Medical Associates Clinic

 

 

 

Sleep Apnea and Heart Disease, Stroke

Elderly man lost in thought

Plain old snoring can get a little annoying, especially for someone listening to it. But when a snorer repeatedly stops breathing for brief moments, it can lead to cardiovascular problems and potentially be life-threatening.

It’s a condition known as sleep apnea, in which the person may experience pauses in breathing five to 30 times per hour or more during sleep. These episodes wake the sleeper as he or she gasps for air. It prevents restful sleep and is associated with high blood pressure, arrhythmia, stroke and heart failure.

Heart disease is the leading cause of death in the United States, and stroke is also a leading cause of death and disability. High blood pressure is a major risk factor for both.

“The evidence is very strong for the relationship between sleep apnea and hypertension and cardiovascular disease generally, so people really need to know that,” said Donna Arnett, Ph.D., chair and professor of epidemiology at the School of Public Health at the University of Alabama at Birmingham and the incoming president of the American Heart Association.

A Common Problem
According to Dr. Arnett, one in five adults suffers from at least mild sleep apnea, and it afflicts more men than women. The most common type is obstructive sleep apnea (OSA), when weight on the upper chest and neck contributes to blocking the flow of air. OSA is associated with obesity, which is also a major risk factor for heart disease and stroke. Besides obesity contributing to sleep apnea, sleep deprivation caused by sleep apnea can, in an ongoing unhealthy cycle, lead to further obesity. In OSA the upper airway closes off because the muscles that hold it open lose tone. The more weight, the more loss of tone and the more severe the sleep apnea. Each time the airway closes, there is a pause in breathing.

A less prevalent type of sleep apnea is called central sleep apnea (CSA). In CSA the brain doesn’t send regular signals to the diaphragm to contract and expand. There is limited snoring and it has been associated with brain stem stroke because the brain stem is where the impulse to breathe comes from.

Listen to Those Snoring Complaints
A roommate or sleeping partner of someone with sleep apnea often notices it. “It’s really hard to detect if you live alone, unless you go through a sleep study,” Dr. Arnett said. People with sleep apnea may be more tired during the day and therefore prone to accidents or falling asleep.

Getting Proper Treatment
Through treatment known as continuous positive airway pressure, or CPAP, blood pressure is stabilized. The CPAP device involves wearing a mask while sleeping. It keeps air pressure in the breathing passages so they don’t close down.

In a sleep study, doctors count pauses in breathing to determine whether the patient has mild sleep apnea, characterized by five to 15 episodes per hour; moderate sleep apnea, defined by 15 to 30 per hour; or severe sleep apnea, meaning more than 30 each hour.

It’s certainly possible to have simple, loud snoring without sleep apnea. But with regular snoring, the person continues to inhale and exhale. With sleep apnea, the sleeping person tends to have periods when he or she stops breathing and nothing can be heard. The good news is treatment that keeps the breathing passages open and oxygen flowing can yield fast results, Dr. Arnett said. “Blood pressure comes down really quite quickly.”

Getting Good Rest
If you’re struggling to get a good night’s sleep follow some of these suggestions:

  • Get regular physical activity, but don’t do it right before bed because that gets your adrenaline pumping and can keep you awake.
  • Limit alcohol consumption to one drink per day for women and two drinks for men; too much alcohol interferes with sleep.
  • Avoid caffeine before bed.
  • Develop a pre-bedtime routine such as taking a warm bath, dimming the lights or having some herbal tea.

If you are experiencing symptoms of sleep apnea, be sure to discuss this with your primary care provider. A referral to a pulmonologist may be necessary. At Medical Associates, Dr. Mark K. Janes is Board Certified in sleep medicine and provides diagnosis and treatment of sleep disorders including sleep apnea. Examination of abnormalities of sleep is available with overnight trend oximetry and polysomnography.

 

Source: www.heart.org