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“The Johns Hopkins study is believed to be the first to evaluate the effects of exercise on the heart’s ability to function, to pump and to fill up with blood.” Johns Hopkins Medicine, News Release, July 27, 2006

Exercise Improves Heart Function

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More Fitness and Less Abdominal Fat = Stronger Heart

Some people, especially those with high blood pressure, are afraid to exercise, because they think it might be harmful to their heart. Just the opposite is true, according to a study published by exercise scientists at Johns Hopkins University School of Medicine in the July 2006 issue of the journal Heart.

They recruited 104 healthy men and women ages 55 to 75 with mildly elevated blood pressure (untreated). Half did moderate exercise three times a week, aerobics and strength training, for six months; the other half continued as usual. All participants were evaluated for heart size, heart chamber (left ventricular) function, peak oxygen uptake, muscle strength, general and abdominal fatness, and insulin resistance—before and after the six month intervention. The exercisers and controls were then compared.

Strength training consisted of two sets of seven standard exercises (whole body) for 10-15 reps; resistance was increased when the subject could do15 reps without difficulty. Aerobic exercise was 45 minutes at 60-90% of maximum heart rate on the participant’s choice of treadmill, stationary bicycle, or stair stepper; workload was increased to maintain heart rate at target levels. Each session began with warm up, followed by resistance training and then aerobic training. Only one exerciser fell below 80% compliance 

At six months, oxygen uptake, muscle strength and lean muscle mass were significantly higher among exercisers than among controls. Fatness and insulin resistance was significantly decreased among exercisers compared to controls.

Taken as a group, the exercisers did not show any change in heart size from baseline to six months. This is actually a plus, because a long-term effect of high blood pressure is an enlargement of the heart that stiffens and weakens the heart. Concerns that temporary spikes in blood pressure during exercise would have adverse effects proved to be unfounded. Among other positive effects, the exercisers as a group showed an almost 3% decrease in resting diastolic blood pressure (the bottom number)

Importantly, the exercisers who made the most gains in physical fitness and those who lost the most abdominal fat showed beneficial changes in heart function.

The Fit Heart

“We found no evidence of adverse effects of exercise on cardiac size or LV [left ventricular] function,” the researchers wrote in Heart.

While there was no change in heart size and function as a group, individual participants with the greatest increase in VO2 max and those with the greatest decrease in abdominal fat did show “a modest trend toward increased” heart size and function.

The specific changes are technical and hard for one not familiar with cardiac terminology (including me) to decipher. Here’s how the effects of exercise are related in the press release: “Each single point gain in aerobic fitness, as measured by peak oxygen uptake, translated to a 1.5 percent improvement in one key measure (the E/A ratio) of diastolic heart function. In addition, every 10-point decrease in abdominal fat translated to a 1.2 percent gain in a second key measure (the Em/Am ratio).” Diastolic function is the relaxed heart chamber filling with blood before the chamber contracts forcing the blood into the arteries. 

“Unlike the increased heart size that results from high blood pressure,” the press release continues, “any increase in heart size in the active group was similar to what athletes experience when their hearts get bigger and stronger, not stiffer.” (Emphasis mine) The researchers called the changes shown by the most successful exercisers “physiological hypertrophy” as opposed to “pathological hypertrophy.” In short, the enlargement was healthy, not an indication of disease.

It seems likely that the changes would be more pronounced in someone who has trained over a longer period of time. I’ve been training for years and my heart is not enlarged. My blood pressure is low, however, especially after exercise, suggesting that my cardiovascular system is flexible.  

According to the press release, aerobic fitness in the exercisers increased by 17 percent, as did average strength. The average weight loss was only four pounds, because much of the loss was offset by increased muscle mass. The fat in the abdominal region was reduced by 20 percent.

“Making gains in body fitness and losing abdominal fat are important to long-term health of the heart,” study co-author and cardiologist Edward Shapiro, MD, said in the press release. “Our results confirm that moderate-intensity exercise can have many health benefits—including gains in heart function that are linked to increased fitness and reduced fatness.” 

Dr Shapiro continued: “Our study also shows that the vast majority of older people with mildly elevated blood pressure can benefit from moderate exercise.”

“The Johns Hopkins study is believed to be the first to evaluate the effects of exercise on the heart’s ability to function, to pump and to fill up with blood,” the press release states. It is also the first to examine “the separate effects of exercise on blood pressure, heart structure and cardiovascular function.”

Again we have confirmation that exercise, weights and aerobics, pays big dividends.

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