Cardiovascular Disease- How to Reverse Heart Disease

Clinical cardiopulmonary exercise testing:

• This testing may provide valuable diagnostic data for a patient’s poor exercise capacity, assist evaluation of disease conditions, and safely evaluate the patient’s ability to start and continue an exercise program.
• Monitors uptake of oxygen, EKG, blood pressure, ventilation, and perceived exertion using a treadmill or cycle ergometer (86).
• A motivated patient interested in improving their health status despite chronic disease conditions will greatly benefit from a referral for cardiopulmonary exercise testing.
• Exercise testing will be able to evaluate a patient’s response to exercise while taking medications. An example includes medications such as beta blockers, including labetalol, which decrease heart rate and blood pressure during rest and exercise. Beta blockers will also increase baseline exercise capacity in patients with pre-existing angina and will either decrease exercise capacity or have no effect in those patients without angina. (31)
• The 6 minute walk test is a simple test using an area for the patient to walk such as a hallway to determine the distance traveled in 6 minutes. The patient is instructed to walk as far as possible at their desired intensity without jogging. The items required include a timer, cones to mark turnarounds, lap counter, and safety equipment such as defibrillator, crash cart, emergency personnel, oxygen, and chair in the walking area. However, thousands of subjects in several studies have previously performed the test without adverse events. It is contraindicated in those with myocardial infarction or unstable angina within the past month, heart rate over 120 and blood pressure of 180/100. (86,87)

Exercise and Asthma According to the National Heart, Lung, and Blood Institute (NHLBI):

Exercise induced asthma or bronchospasm (EIB): In adults and children with asthma, taking inhaled short and long acting beta2-agonists (such as albuterol, salmeterol, formoterol) before vigorous activity or exercise may prevent EIB, exercise induced asthma, in about 80% of patients. The benefits of treatment may last for 2-3 hours for short  action beta agonist or up to 12 hours if long action beta agonists are used. Additionally, a warm-up period prior to exercise is associated with a lessen degree of EIB. In cold weather, a mask or scarf over the mouth may lessen the effects of cold-induced EIB. Children suffering from EIB should not be excluded from sports and other activities but teachers and coaches should be notified that the child suffers from EIB and may need inhaled medication prior to participation. If symptoms of EIB occur during usual non-vigorous play activities, this may an sign of poorly managed or persistent asthma and long-term treatment may be necessary. Appropriate long-term management may reduce EIB. (93)