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    HEART ATTACKS AND WOMEN

     

    HEART ATTACKS AND WOMEN
    Walking reduces risk

    Physicians have known for years that people who exercise regularly have a lower risk of heart disease. But what types of exercise and how often? And, since much of the existing research involved men, there was scant evidence on whether exercise offered women the same protective effects against heart disease that men who exercise apparently receive.

    A study published in the Aug. 26, 1999, issue of the New England Journal of Medicine indicates that women can reduce their risk of coronary heart disease by 30 percent to 40 percent simply by walking briskly for 3 or more hours each week.

    Physicians have known for years that people who exercise regularly have a lower risk of heart disease. But what types of exercise and how often? And, since much of the existing research involved men, there was scant evidence on whether exercise offered women the same protective effects against heart disease that men who exercise apparently receive.

    A study published in the Aug. 26, 1999, issue of the New England Journal of Medicine indicates that women can reduce their risk of coronary heart disease by 30 percent to 40 percent simply by walking briskly for 3 or more hours each week.

    One-third of coronary events in middle-age women in the United States can be attributed to a sedentary lifestyle. Each year, heart attacks strike about 74,000 U.S. women between the ages of 45 and 64, according to the American Heart Association.

    Is walking as good as jogging or running for your heart and cardiovascular system?

    From a fitness standpoint, we know that you will derive a higher level of fitness as measured by a stress test from more vigorous exercise. However, the results of this study indicate that when it comes to the reduction of cardiovascular risk and mortality, it appears that duration of the exercise is important. The women in the study who spent more time walking appear to have the greatest benefit. At least in this study, it didn't appear that those who spent the same amount of time running got a lot more benefit.

    Are this study and its findings significant?

    Yes. It confirmed what we already believed. It's reassuring that the findings didn't contradict what we've been recommending for women. One point that ought to be made is that these findings may not apply to every woman. The study involved a pretty homogenous group - nurses 40 to 65 years old. They're highly educated and very much aware of health issues.

    Given the study's findings, if someone is now enrolled in an aerobics class, or doing some other intense exercise, should they stop and go for a walk instead?

    I don't think this study says that walking is as good as doing more vigorous exercise. It didn't really compare them. In fact, the researchers state: 'Our ability to assess the role of vigorous exercise was limited because of the small number of women in the study population.' However, the researchers also found that women who engaged in both walking and vigorous exercise had greater reduction in coronary events than those who did either type alone. So, you could tell someone who goes to a step aerobics class 3 days a week that they could reduce their risk of heart attack even more by walking briskly on the other 3 or 4 days. I think what's most exciting about this study is that it shows that something that is simple and low-tech works.

    It works, and with a low risk of injury?

    Right. Walking is the most favored exercise for women of this age group. There aren't a lot of 55-year-old women out there running, swimming vigorously or biking. They're the most likely people to walk. To show that the activity that most women might choose to do actually helps prevent heart attacks is great news. I hope it will help motivate women who aren't currently doing any physical activity to 'get moving.'

    What's the take-home message here?

    Move more for longer periods of time. People should do at least 30 minutes of moderate intensity physical activity on most - and preferably all - days of the week. To put that into numbers, walking at least 3 hours a week at a pace of at least 3 mph (20-minute miles). That's a brisk walk -- one that makes you begin to sweat lightly. This has been my No. 1 push clinically because the benefits involve much more than just cardiovascular health. This study also is important because it shows that women who started as non-exercisers but later increased their activity really reduced their cardiac risks compared to those women who stayed sedentary. The bottom line? It's never too late to get these benefits.

     






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