The structure and function of the cardiovascular system (arteries, veins, heart and lungs) and the ability of the components to work together is critical for healthy, functional and independent living. As we age, activities that seemed relatively easy to perform just a few years earlier become more difficult as our ability to produce the needed energy to perform work declines.
The wall of the chamber of the heart that pumps blood to the rest of the body increases in thickness by about 30% beginning at around age 25. This wall thickness may be in response to an age related increase in blood pressure. The aorta and arterial tree (the arteries that deliver blood to your muscles and organs) also become thicker and less compliant with age. As well, with age the heart and blood vessels become less sensitive to neurological stimulation. This means that the aging heart can’t achieve maximum heart rates that were possible during your younger years and blood pressure reflexes that accommodate for a change in pressure as we change positions from sitting to standing do not respond well and this often results in dizziness, confusion, weakness or fainting as the older adult stands up.
Fortunately, regular cardiovascular exercise can slow down many of these anatomical and physiological changes that occur with aging. Cardiovascular training (exercise that involves increasing your heart rate for a sustained period of time) has been shown to reduce the risk of cardiovascular disease, decrease resting heart rate, keep resting blood pressure normal, improve heart efficiency, increase your energy and build stamina.
The following table outlines Cardiovascular Training Guidelines. It should be noted that these are only guidelines and before you start any regular physical activity program you should have a medical examination and clearance from your doctor.
Table 1: Cardiovascular Training Guidelines for Adults 50+
|
Description |
Beginner (Very low to Low Fitness) |
Intermediate (Average Fitness) |
Advanced (Above-Average Fitness) |
| Goals | 1. Improved health2.Increase energy3.Daily activities made easier4.Weight reduction | 1.Improved health2.Weight Reduction3.Advanced activities of daily living (ie.- participation in sporting activities such as golf & bowling, gardening) made easier | 1.Improved health2.Weight maintenance3. Sports training for competition. |
| Frequency | 1-3 times / week | 3-5 times / week | 4-6 times / week |
| Intensity (see note 1) | 55%-64% Max HRRPE -9-12 | 65%-74% Max HRRPE- 12-15 | 75%-90% Max HRRPE – 13-16 |
| Time | 15-30 min.(Initially this does not have to be continuous) | 20-45 min. | 40-60 min. |
| Type | 1.Walking2.Staionary bike3. Swimming4.water aerobics5.Basic fitness classes | 1. Stair climbing2. Treadmill3. Fitness Classes4. Cycling (spin) classes5.Cross-training | 1. Complex movements2. Sports3. Interval training4.Cross-training |
Note 1:
There are many options to be used to determine exercise intensity.
1. Target Heart Rate
Step 1: Determine your maximum heart rate;
Formulas;
- 207- (.7 x your age) (eg.- 207 –(.7 x 55 yrs of age) = 169 bpm)
- male – 220-age, female 226-age
Step 2: Determine Target Heart rate range;
- Max HR x lower % (eg.- 169 x 55% (beginner) = 93bpm
- Max Hr x higher % (eg.- 169 x 64% (beginner) = 108 bpm
Summary – for a 55 year old who is a beginner (very low to low fitness level) they would try to raise their heart rate to between 93 and 108 bpm for 15-30 minutes (initially the activity does not have to be continuous).
2. Rate of Perceived Exertion
This method to monitor exertion uses the Borg Scale of exertion between 6 and 20.
Table 2: Borg Scale of Perceived Exertion
| 6 | |
| 7 | Very, very Light |
| 8 | |
| 9 | Very light |
| 10 | |
| 11 | Fairly light |
| 12 | |
| 13 | Somewhat hard |
| 14 | |
| 15 | Hard |
| 16 | |
| 17 | Very Hard |
| 18 | |
| 19 | Very, very hard |
| 20 |
Example – An intermediate (average fitness) 50+ adult should do cardiovascular exercise at a perceived exertion level between 12 & 15 for 20 to 45 minutes 3 to 5 times per week.
3. Talk Test
If you are breathless and unable to talk, the intensity is too high and you should slow down immediately.
Effects of Medications on Heart rate
It is important to note that medications may affect heart rates. Table 3 list medications that are commonly prescribed to the 50+ adult and may affect heart rate. As noted earlier you should consult with your medical doctor before engaging in regular physical activity.
Table 3: Commonly Prescribed Medications and their affect on Heart Rate
| Medication | Heart Rate at Rest | Heart Rate during Exercise |
| Beta Blockers | Lower | Lower |
| Nitrates | Increase | Increase |
| Calcium Channel Blockers | Increase | Increase |
| Digialis | Neutral affect | Neutral affect |
| Antiarrhythmic Agents Class 1 | Neutral or increase | Neutral or increase |
| Diuretics | Neutral affect | Neutral affect |
| ACE Inhibitors | Neutral affect | Neutral affect |
| Antidepressants | Neutral or increase | Neutral or increase |
| Nicotine | Neutral or increase | Neutral or increase |
| Thyroid Medication | Increase | Increase |
| Bronchodilators (Methylxanthines) | Neutral or increase | Neutral or increase |
| Bronchodilators (Sympathomimetic) | Neutral or increase | Neutral or increase |
| Bronchodilators (Cromolyn Sodium) | Neutral | Neutral |
| Bronchodilators (Corticosteroids) | Neutral | Neutral |
Cardiac Risk factors
As mentioned, it is important for safety reasons to have a medical examination
before you start a regular exercise program. This is even more important for the 50+ adult who has experienced anatomical and physiological changes with their cardiovascular system as they have aged. The following are a list of conditions that raise the 50+ adult’s risk of cardiovascular disease.
- Age
- Family history of heart disease
- Smoking
- High blood pressure (Hypertension) – Systolic pressure > 144 or diastolic pressure greater than 94).
- High cholesterol levels- total cholesterol over 200 milligrams per decilitre)
- Diabetes
- Sedentary life style – less than 60 minutes of light effort performed daily, less than 30 min. of moderate-intensity activity 4 times a week, or less than 20 minutes of vigorous activity 4 times a week.
Signs and Symptoms of Cardiovascular Distress
If you are exercising and experience any of the following symptoms you should stop exercising immediately and consult your doctor or go to the hospital.
- Pain and discomfort in the chest, lower jaw or left shoulder.
- Feeling of rapid, throbbing heart rate.
- Sever pain in leg muscles when walking, running or cycling
- Shortness of breath or difficulty breathing.
- Feelings of dizziness or fainting
Summary
Cardiovascular exercise for the 50+ adult is a key component to improved health, functional independence and quality of life. With proper medical screening and following specific training guidelines it can be performed safely and effectively. Increased endurance, loss of weight, increased self esteem and self image are just some of the many benefits from engaging in this form of exercise. “Success is in the Doing” so you should get started right now.
If you’d like more info please contact Mike.