It's rare to find a doctor who actively recommends exercise to heart disease patients. Most patients and their families worry, "Isn't it dangerous to exercise when you have heart problems?" But after hearing from Professor Lee Jong-yeon (Cardiology), you'll gain a completely different perspective.
Lack of Exercise is Actually the Biggest Risk Factor
There's one crucial fact we're overlooking:far more patients come to the emergency room due to lack of exercise than from over-exercising.
Until the 1960s, the standard treatment for acute myocardial infarction patients was 8 weeks of complete bed rest. Patients had to urinate and defecate in bed, and were even spoon-fed their meals. Since heart attacks were considered so dangerous, the rule was absolute immobility.
But by the 70s and 80s, this approach completely changed. Today,"Exercise is Medicine"has become common knowledge in the medical community. However, this shift hasn't been fully reflected in clinical practice yet.
Even Heart Attack Patients Can Complete Marathons
There's an amazing study conducted by Dr. Kavanagh in Canada. He systematically trained 8 heart attack patients and had them participate in the Boston Marathon. One doctor and 8 patients ran together, and 7 out of 8 completed the full 42.195km course. The one who didn't finish stopped not because of heart problems, but due to foot pain.
This case demonstrates thatwith systematic, safe, and gradual increases in exercise intensity, even heart disease patients can handle extreme physical challenges. Of course, this doesn't mean suddenly running a marathon. The key is gradual, step-by-step progression with careful monitoring.
The Amazing Effects of Exercise: 3x More Powerful Than Medication
Looking at specific numbers shows just how remarkable exercise effects are:
-Aspirin: 10% reduction in cardiovascular mortality
-Statins (cholesterol medication): Around 10% mortality reduction
-Beta-blockers and all heart medications combined: Around 30% total
-Exercise: 30% reduction in cardiovascular mortality
Exercise is three times more effective than aspirin, which heart disease patients must take. The effect of exercise alone is comparable to all heart medications combined.
How to Measure Proper Exercise Intensity
Many people exercise without seeing results. When patients say "Doctor, I exercise," and I ask "What kind and how much?" they often respond, "I walk for an hour." But low-intensity activities like casual walking don't provide cardiovascular benefits.
You needmoderate-intensity exerciseto see effects. Here are three ways to measure this:
1. Subjective Feel
After 30 minutes of exercise, you should feel slightly out of breath and think "I actually worked out today."
2. Talk Test
You can hold a conversation while exercising, but you couldn't sing a song.
3. Heart Rate (Most Objective)
Start with resting heart rate + 40, increasing by 10 each week.
For example, if your resting heart rate is 100, maintain 140 for 30 minutes the first week, then 150 the next week, 160 the following week, and so on.
Direct Effects of Exercise on Blood Vessels
Here's what happens in your body when you exercise:
Blood Clot Prevention
When blood flows faster, do clots form more easily or get cleared away? Obviously, debris can't accumulate in fast-flowing water. Exercise increases blood flow speed, washing away existing clots.
Vessel Dilation
The muscle layer in arteries stretches due to exercise, directly increasing the vessel's internal diameter.
Collateral Circulation Development
Just like taking side streets when the main road is blocked, exercise develops small vessels around the heart (collateral circulation). When major vessels are blocked, well-developed bypass routes increase the heart's survival chances.
Muscle Metabolic Improvement
When muscles grow from strength training, they consume harmful substances like blood sugar, blood pressure, and cholesterol, preventing insulin resistance.
The Perfect Exercise Prescription
Exercise Components (Total 1 hour)
-Aerobic exercise: 30 minutes (walking, running, cycling, etc.)
-Strength training: 15-20 minutes (weights, bodyweight exercises, etc.)
- Stretching: 5-10 minutes (yoga, Pilates, etc.)
Exercise Frequency
150+ minutes per week (about 20-30 minutes daily)
Intensity Control
First week: Resting heart rate + 40
Increase by 10 each week, reassess after 3 months
Simple Exercises You Can Do at Home
Calf Raises (Second Heart Exercise)
Hold a chair and slowly lift your heels up and down 10 times. Calves are called the "second heart" because they're so important for circulation.
Chair Squats
Hold a chair and lower yourself as if sitting down, then stand back up. Keep knees from going forward, inhale going down, exhale coming up.
Wide Squats
Spread feet wider than shoulders and repeat the same movement. This targets glutes and inner thigh muscles more intensively.
Do these movements for 6-7 minutes while playing 2 trot songs for effectiveness.
Warning Signs to Stop Exercise Immediately
Stop exercising immediately and see a doctor if you experience:
- Chest pain
- Severe shortness of breath
- Dizziness or fainting
- Extreme fatigue
- Feeling much more difficult than usual
Diabetic patients should also avoid exercise when blood sugar is too high or too low.
Utilize Cardiac Rehabilitation Programs
There's a government-mandated system requiring cardiac rehabilitation treatment for cardiovascular patients. If your current hospital doesn't have a program, all tertiary hospitals do.
Amazingly, these programs cost less than gym memberships. They have nearly 1,500 square feet of space with better equipment than most gyms, plus physical therapists and exercise specialists providing personalized prescriptions. Yet only 5% of eligible patients actually use them.
Occupational Physical Activity Isn't Exercise
Some people say, "I deliver packages, so I get plenty of physical activity," or "Cleaning work is like exercise for me." But occupational physical activity isn't exercise.
Exercise is something you dowith joy and pleasure, with the mindset of 'I need to do this for myself.'Work-related activities involve too much stress, so even people with physically demanding jobs need separate exercise.
The Concept of Exercise Snacks
For busy modern people, there's a new concept called "Exercise Snacks." Just like eating small snacks throughout the day adds up to a full bag, short 10-second bursts of exercise can accumulate to equal longer workouts.
Daily activities like taking stairs or walking instead of using elevators become exercise when done with the mindset of "I'm doing this for my health."
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In conclusion, exercise is the world's cheapest, most effective treatment with no side effects. Rather than avoiding exercise because of heart disease, you should be more proactive about systematic exercise.
Consistently doing the three-part combination of moderate-intensity aerobic exercise, strength training, and stretching for 150+ minutes per week provides more powerful effects than any medication. If you've been diagnosed with heart disease, actively utilize cardiac rehabilitation programs. If you're healthy, starting exercise right now is the most reliable health investment you can make.
*Source: Reconstructed based on Professor Lee Jong-yeon's interview*.
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