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Expert advice: Heart health

Chris Saunders
7 Nov 2016

What every cyclist needs to know about their heart works and how best to take care of it

OK, strap yourself in – it’s hard facts time: heart disease is the biggest killer in the world.

Like the worst kind of dirty bomb, it’s a disease that doesn’t discriminate and costs the NHS around £15 billion a year.

In the UK, where one in five smoke and one in four are clinically obese, there are an estimated seven million people living with heart disease right now, and it will kill one in seven men and one in 10 women. Someone in the UK dies from heart disease every eight minutes.

Shocking stuff, right? But the good news is that, apart from regular riding having a positive impact on your general health, most active cyclists are more in tune with their bodies, and therefore more likely to recognise the signs of any health problems before they become serious.

But just because you ride, it doesn’t make you immune. Knowledge is your most powerful ally. So here are some useful facts to keep in your locker that might just save your life…

Be a regular guy

We all know the health benefits of regular exercise. Adults who are physically active are 20–30% less likely to suffer premature death and have up to 50% lower risk of developing major chronic diseases such as diabetes, cancer and coronary heart disease (CHD).

Which is why heart health is so important. While there is no such thing as ‘bad’ exercise, some are better than others with cycling among the most beneficial forms of it you can do.

According to a study by the British Medical Association, cycling just 32km (20 miles) a week reduces the potential to develop heart disease by a whopping 50%, because it uses large muscle groups in the legs to elevate your heart rate, which in turn improves cardiovascular fitness.

Hence it’s very good for the heart. If you’ll excuse the pun, cycling keeps things ticking along nicely.

But it’s only half the battle, as Christopher Allen, Senior Cardiac Nurse at the British Heart Foundation, told Cyclist: ‘When it comes to maintaining a healthy lifestyle, you cannot balance eating unhealthily against the amount of exercise you do and vice versa.

‘It’s a myth that stress leads to heart attacks as there has to be underlying disease in the arteries of your heart. It’s more about behaviours when you’re stressed that contribute to a heart attack, such as smoking and eating unhealthy food.

‘Also, heart disease can affect anyone, no matter what his or her age. Babies can be born with heart defects or inherit a genetic condition from their parents, which can lead to sudden death.

‘Smoking is one of the worst things you can do for your heart, but equally important is your risk profile. This is all of your health behaviours combined, plus things like your family history and ethnicity.’ 

The science bit

OK, that’s the top and bottom of it. Now let’s arm ourselves with some serious knowledge.

First, some basic biology. The heart is made up of four chambers; the left atrium, right atrium, left ventricle and right ventricle, and contains four valves which ensure that blood goes either in or out – a bit like traffic lights on a one-way system – and the sound of a heartbeat is these valves opening and closing.

Blood leaving the heart is carried through arteries, the main one attached to the le ventricle being the aorta, while the main artery leaving the right ventricle (towards the lungs) is called the pulmonary artery.

Blood coming from the lungs to the left atrium is carried through the pulmonary veins, while blood coming from elsewhere to the right atrium is carried through what’s known as the superior vena cava and inferior vena cava.

A heart attack is caused by the blood supply to the heart being interrupted, which usually happens when one or more arteries become blocked.

Over time, the build up of various substances such as cholesterol can make them narrower. These deposits are called plaques. Sometimes these plaques rupture causing blood clots which then block the blood supply to the heart.

This condition, known as coronary heart disease (CHD), is the root cause of most heart attacks and is why full English breakfasts and cheeseburgers get so much bad press.

Nevertheless, there is a lot of confusion around the issue. Christopher Allen clears things up for us: ‘Although a heart attack can lead to a cardiac arrest, they’re not the same thing. A heart attack is a sudden interruption to the blood supply to part of the heart muscle.

‘It’s likely to cause chest pain and permanent damage to the heart. The heart is still sending blood around the body and the person remains conscious and is still breathing.

‘A cardiac arrest, meanwhile, occurs when the heart suddenly stops pumping blood around the body. Someone who’s having a cardiac arrest will lose consciousness and will stop breathing, or stop breathing normally.

‘Unless immediately treated by CPR, this leads to death within minutes. Sudden cardiac arrests are most commonly caused by inherited heart conditions, which include hypertrophic cardiomyopathy and Long QT Syndrome.

‘Remember, the heart is a muscle, and needs exercise like any other muscle. Cycling’s a great way to get the government-recommended 150 minutes minimum amount of physical activity per week.

‘To gain the health benefits of being active, people should aim to be physically active at a moderate intensity. Moderate intensity activities will make you feel warmer, breathe harder and make your heart beat faster than usual, but you should still be able to carry on a conversation.

‘Cycling is a great example of moderate intensity physical activity. Roughly speaking your maximum heart rate during exercise is 220bpm minus your age.

‘So if you are 35, your maximum heart rate should be 185bpm. Always remember to build up your level of exercise gradually, however. If you are already active, consider some bouts of vigorous activity, like HIIT (High Intensity Interval Training), to further improve your fitness.

‘Vigorous activities should make your heart beat more rapidly, making it more difficult to carry on a conversation.’

According to Allen, however, you should always ease yourself into exercise no matter how fit you are.

‘A warm-up at the beginning is advisable,’ he says, ‘because it allows your heart rate to increase gradually, as it pumps blood to your muscles. It also gradually increases your body temperature.

‘Meanwhile, an effective warm down helps to bring your body back to its resting state while also, of course, helping to reduce muscle soreness.

One last fact before we move on: seven out of 10 heart-attack victims survive these days thanks to improved medical care compared to three out of 10 in the ’60s. It’s not a statistic we recommend you putting to the test, though!

Watch out for warning signs

However careful and well prepared we are, heart attacks can still strike at any time, so it pays to be aware of the warning signs.

Common symptoms include pain in your chest, arms, neck, jaw, back or stomach; sweating, light-headedness, shortness of breath or nausea.

Symptoms of conditions like an abnormal heart rhythm, meanwhile, include palpitations, dizziness and lethargy.

Triathlete, MD, and heart surgeon Larry Creswell, says that everyone feels pain differently, and no two sets of symptoms are the same.

‘The defining characteristic is that pain is brought on by exercise and subsides when you rest,’ he told us.

‘Other symptoms should still demand your attention, however. Pay attention any time you have the sensation of having an abnormal heartbeat.

‘This is where your heart rate monitor can really help. If your heart is suddenly zooming along at 210 beats per minute for no good reason, that’s a sign to get checked out.

‘Same thing goes if you’re at home going through your data file and you see episodes where your heart rate is pushing 200 when you felt like you were going along at 125.’

It’s worth noting that excessively high readings can also be caused by glitches in your heart-rate monitor, so always double check your figures but as a rule of thumb, if something doesn’t feel right, it probably isn’t.

Similarly, as a cyclist, no matter what your level, you’ll know your breathing pattern. When it doesn’t feel normal for the exertion level you’re at, particularly if you’re cruising along, and suddenly find yourself working to catch your breath, something could be wrong.

‘You could be fatigued or coming down with a cold or virus,’ Creswell says. ‘But it’s a warning sign and if it’s unexplained, you need to get it checked out.’

Fatigue is one warning sign. Another is almost blacking out, or even worse, actually blacking out.

That obviously has its own dangers especially if you happen to be riding at the time, but in the long term, it could also be an indicator of some more serious underlying heart problem.

The last word goes to Christopher Allen. ‘Always report symptoms to your GP, and if you think you’re having a heart attack dial 999 immediately.

‘Before you undertake any intense physical activity or start training for an event, arrange an appointment with your GP for a general check-up. You won’t regret it.’

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