exercise

[jean]

I am a 52 year old woman.  I had a very mild silent MI approximately two years ago.  I have been walking about 1-1/2 miles a day, five or more days a week ever since and have lost about 50lbs.  This past year I have been taking 100mg of Toprol XL & 25mg of Cozar.  My blood pressure is under control & I feel healthier than ever. I just added to my exercise regime a 3-times a week weight training program with a personnel trainer.
My question is, given that the medicine I take can lower the heart rate and keep it lower during exercise, how do I adjust the target heart rates I find on charts to achieve a good cardio workout?  Does my weight or asthma medicine affect the heart rate as well?
Thanks

[Cleveland Clinic, MD]

I don't know what to tell you but to hang in there and it will get better.  Most people do not work out for long-enough or at a high enough intensity to see benefits.  So keep working out most days of the week for at least 40min to an hour and you eventually will start to notice an improvement.

[Cleveland Clinic, MD]

This means you are out of shape.  In general it is better to start with a lower workload for a longer period (i.e. 40min) than a high workload for a short period (i.e. 10 minutes).  Therefore, if you can maintain 143 for 40 minutes then great.  If you are having troubles than go a little slower for longer.

[Cleveland Clinic, MD]

Congratulations on the progress.  I would go more by how you feel and less by the heart rates.  Work-out until you feel fatigued but not exhausted.  Probably about 40 minutes at a moderate workload.  The wieght or asthma meds will not affect heart rate.

[Anne]

I am a little confused about being out of shape.  I'm not saying I'm an athlete, but certainly my fitness has improved over the last year.  Since Jan 99 I have been working out at least five days a week, with a combination of strength training via nautilus equipment and aerobic machines 3 days a week, and one hour of swimming at least two days a week.  The other two days I usually walk, but since I walk with an older friend we don't go fast enough for me to count it.  I use the YMCA and had a fitness evaluation at the beginning in January, I scored poorly being out of shape in many areas, and my resting heart rate was in the 90s.  Except when ill I have been good about keeping up the fitness regime, keeping it all documented helps since I like to see the progress.  After about four months I had a re-evaluation and had improved my fitness in every area, I had lost 10 pounds at that point and my resting pulse was in the 70s.  Strength and flexibility were also improved, my weight loss consisted primarily of
fat tissue and my muscle mass had increased.  I continued the regime taking off only when ill and returning right away when improved.  I have lost a total of 22 pounds now.  However, about two months ago, my resting heart rate increased to above what it was before I started the fitness training.  The YMCA instructors are at a loss, and I think are a little worried about me exercising.  The fast heart rate is higher than before I even started the fitness program, even though I weigh 22 pounds less (I am still heavy, but I would consider that an improvement).  After all those months of hard sweaty work, fighting with arthritis pain and making a real effort to stay committed....I am now more exercise intolerant than I was before I started.  I don't understand how I can be more deconditioned now than I was at the beginning of my program.  I have had a normal echo, so don't think it is a heart problem.  Nonetheless, it confuses me that I went backwards so dramatically.  I could understand hitting a plateau even,
but can I really be more out of shape now after almost a year of regular, fairly intense exercise, monitored by fitness trainers who have seen to it that I continually increase both strength and aerobic training?  Does this commonly happen?  Will the decline go away as quickly as it came, restoring me to the level of fitness I previously had.  It is pretty depressing to go downhill so rapidly....I kind of expected to keep improving.
Anne

[Anne]

I have a similar question....my resting heart rate is quite high at about 110-120 and at 42 my maximal rate is supposed to be 178 and my cardio rate suggested at 143....I hit the 143 within the first 60 seconds of exercise and within three to four minutes will be at or above the maximal rate, I usually have to quit at that point because I cannot keep going I get short of breath and dizzy.  I can work the strength machines and the heart rate stays in the 140-150 range and I feel ok, it is the aerobic machines (treadmills, bikes, stairmasters, even swimming) that causes the rise in heartrate.  How does the quick rise affect the training effort....does my heart rate need to go higher to get a good training effect since my starting rate is so high....and if I can keep forcing myself to go on at or above maximal rates will it hurt anything.  I have had basically normal ekgs and echos and holters showing only minor abnormalities such as some ST segment depression, PVCs, and sinus tachycardia, mild right atrial
enlargement....but the final report and cardiologist assures me these changes are basically insignificant and it is ok to exercise.  That is why I am wondering about the heart rate, and how much I should push it, I could probably make myself go a bit longer even at the maximal rates if I didn't get scared by it.
Anne