THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 526.2 Guest: Dr. Michael Miller, Director of Preventive Cardiology, U. Of Md. Medical School Topic: Exercise and the Elderly - One Part Host: Steve Girard Producer: Ed Graham

NEMA: Let's talk about exercise and the elderly...what's the latest feeling about its benefits?

MILLER: From the standpoint of the heart, that it tends to raise the levels of the good cholesterol, it tends to lower levels of the blood fats, and it increases strength and endurance.which are important factors in the elderly. Studies that were done in the last few years suggested that with small amounts of weightlifting, the elderly patients tended to have great benefits, with respect with both physical functioning as well as mental function.

NEMA: It's not too late for most elderly people to gain the heart benefits of exercise....

MILLER: If you are an elderly individual who has not partaken in an exercise program, than we would certainly want to evaluate you. So, its very prudent to see your physician, and have a complete history, physical examination, and perhaps a stress test....just to make sure that before you start on a regular exercise program, that you're physically fit and capable of doing it.

NEMA: Some simple activities are a great way to get into a better fitness mindset...

MILLER: One of the simpler tasks would be walking. If you could walk several blocks without becoming tired, or without having any symptoms of shortness of breath or chest discomfort, that's a good sign. Doing other kinds of daily tasks, whether its cleaning around the house, shoveling snow....requires a little more energy and therefore, to be able to do those tasks without any discomfort at all, would obviously be a good sign.

NEMA: Diet also plays a role in getting and staying in good heart health...

MILLER: The American Heart Association recommends individuals follow a diet that's low in fat and cholesterol.....and essentially what that means is that an elderly individual should really try to watch his or her fat intake. and cholesterol intake....and by that, we mean trying to keep the total amount of fat less than 30% of calories.

NEMA: What improves in the cardiovascular system with regular exercise?

MILLER: You're increasing the ability of the muscles to extract oxygen, so that oxygen delivery is enhanced and the muscles are able to utilize the oxygen to a greater degree. A lower base line heart rate suggests that the amount of blood being pumped from the heart to the rest of the body is maximized and that the blood flow through the heart arteries is improved. Once the person's in shape, he has the greater ability to extract that oxygen from the blood, that's being pumped from the heart. If somebody has heart disease, blockages in the heart arteries, what happens is that as the blood is being pumped to the muscles, the heart arteries might not get enough blood...and that individual might have symptoms referable to the heart, which might be shortness of breath, or chest discomfort.

NEMA: That's why Dr. Miller says its crucial that an elderly individual who has not been in an exercise program or has symptoms of heart disease has a complete checkup by a physician, in order to ensure they aren't risking a heart attack. I'm Steve Girard.