The View
By DAVID J. HILL
Published February 14, 2023
February is American Heart Month, a time for people to pause and do a reset on their heart health and how they might be able to improve it.
Michael LaMonte, research professor of epidemiology and environmental health, School of Public Health and Health Professions, is an expert on healthy aging whose research has helped inform the federal physical activity guidelines for older adults.
As an investigator on numerous Women’s Health Initiative extension studies — including one currently underway that is the first randomized clinical trial where physical activity is the only intervention modality for the prevention of heart attack and stroke — LaMonte has published a wide range of research on physical activity and how it correlates to heart health.
Here, he offers some tips on how to maintain a healthy heart, including how the things people do every day can count toward hitting their heart health goals.
The good news is, you don’t have to run marathons to maintain a healthy heart. In fact, current physical activity guidelines for the general public recommend a moderate amount and intensity of physical activity. This can include things you already do each day, like yard work or chores around the house, LaMonte says.
“The goal is to accumulate a minimum of 150 minutes per week in moderate intensity activities which, for example, could be achieved by brisk walking for a half-hour five days a week, or walking for 15 minutes in the morning and 15 minutes in the evening,” LaMonte says.
And, he adds, reduce sitting time by cutting down on watching TV or playing video games. Break up prolonged sitting with short amounts of standing, walking in place or short walks. “While this might not contribute to physical activity benefits, per se, it will break the sedentary physiology that contributes to bad health outcomes.”
The key isn’t just in cardio; it’s also important to work on muscle groups at least one day a week. “We lose muscle mass as we get older, and especially with living a sedentary lifestyle,” LaMonte explains. “Maintaining muscle mass not only enhances our ability to engage regularly in activities like walking, cycling, swimming, house work or gardening, etc., but it also helps keep our metabolic rate from decreasing. That’s important for maintaining body weight, as well as for metabolic function related to glucose and cholesterol levels.”
LaMonte recommends focusing on the large muscle groups like legs, upper back, chest and core/abdominals by doing two sets of 15-20 repetitions of a weight or resistance that is challenging, but not so difficult that you can’t complete at least 15-20 reps.
For people who smoke, quitting is the best thing they can do for heart health, LaMonte says. For folks who don’t smoke, it’s important to continue avoiding that. And everyone should know their numbers: body weight, cholesterol, blood pressure and blood glucose, all of which correspond with obesity, high cholesterol and Type 2 diabetes, major heart disease and stroke risk factors that are changeable.
“The single most important misconception — in my opinion — is that heart disease is a ‘man’s disease’ and that women generally have low risk of heart disease and should be more concerned about other health conditions. This is absolutely false,” LaMonte says, noting that heart disease is the leading cause of death in the U.S. among both men and women. In addition, the absolute number of heart disease deaths is higher in women than men, and has been for the past decade or so.
Women will be a particular focus for public health in the coming decades. It is projected that women will outnumber men 2 to 1 among people aged 65 and older by 2050.
“We need to ensure that women are just as vigilant as men when it comes to promoting a health heart, and it should begin early in life,” LaMonte says. “We can’t wait until women go through menopause to worry about their heart health.”
It’s important to be aware of the signs and symptoms of possible heart disease so that you can be proactive in getting things checked out. These include unusual and rapid change in body weight, unusual levels of fatigue when doing physical activity or even at rest, a feeling of breathlessness or a racing heartbeat, newly developed cough, inability to lay flat when trying to sleep, and swelling in the ankles, hands or neck.
“All of these could be indications of an underlying heart issue at any age, but particularly in older adults,” he says. “Talking with your health care provider about any of these symptoms is imperative.”
LaMonte is currently leading the first randomized clinical trial where physical activity is the only intervention modality for the prevention of heart attack and stroke. The clinical trial involves approximately 49,000 participants from the Women’s Health Initiative Strong and Healthy (WHISH) trial and focuses on increasing aerobic physical activity (such as walking) and muscle strengthening (using rubber exercise bands) and reducing sedentary time.
“The goal is to determine if the occurrence of heart attack, stroke and cardiovascular death is lower in these women as compared to a group who received no physical activity or sedentary intervention and were simply followed over time as they went about their usual activities of daily living,” LaMonte says.
“The results of this trial should provide us with a conclusive test of the physical activity effect for heart disease prevention which, in turn, could lead to refinement of public health and clinical medical guidelines for prescribing physical activity to achieve heart health benefits.”