# Exercise as it relates to Disease/Aerobic exercise impact on coronary heart disease
### What is Coronary Heart Disease?

Coronary Heart Disease (CHD), is a disease, in which a plaque (cholesterol substance and fatty deposit) builds up inside the coronary arteries of the heart, narrowing the small blood vessels that provide oxygenated and nutrient rich blood to the heart. The building of a plaque takes many years, the condition when the plaque is already builds up in the arteries is called Atherosclerosis. As a result, blood flow to the heart can slow down or stop. When the flow of oxygen-rich blood to the heart muscle is reduced or blocked, angina, shortness of breath or a heart attack can occur.

### Definition and characteristics of Aerobic Exercise

Aerobic exercise is a moderate intensity and constant physical exercise, which uses oxygen, in which the cardio respiratory system refills the oxygen consumed (in the energy-generating process) into the working muscles. Also it is a physical work which requires additional effort by the heart and lungs to meet the muscles´ increased demand for oxygen. Oxygen is used to "burn" fats and glucose in order to produce adenosine triphosphate, the basic energy carrier for all cells. In general, aerobic exercises are those exercises performed at a moderate level of intensity for extended period of time that maintains an increased heart rate.

## Prevalence of CHD

According to the National Institutes of Health (NIH), USA, CHD is the leading cause of death for males and females in the USA. CHD caused the death of over 425,000 people in 2006. In 2012, CHD caused the death of about 600,000, 1 in every 4 deaths in the USA. More than half of the deaths were in men. According to Heart Foundation, Australia, CHD claimed the lives of over 21,500 Australians (14% of all deaths) in 2011. CHD kills 59 Australians each day, or one Australian every 24 minutes.

## CHD Risk Factors

Below is a table of both Modifiable and Non-Modifiable risk factors of CHD
| Modifiable Risk Factors | Non-Modifiable Risk Factors |
| Tobacco Smoking status High Blood Pleasure High Blood Cholesterol ( High LDL or Low HDL ) Diabetes Obesity Lack of exercise Diet Emotional/mental stress | Increasing Age Gender (Men are greater risk. However, the risk for women increases after menopause) Gene type Family History of CHD |

## Benefits of Aerobic Exercise in CHD

Some of the benefits are:
* Strengthen the heart and cardiovascular system
* Keep the cholesterol at a healthy level. Reduction in bad (LDL and total) cholesterol and Increase in good (HDL) cholesterol
* Improve the circulation and help the body use oxygen better
* Lower blood pressure, keep the blood pressure at a healthy level
* Improving coronary Artery Vasomotion
* Make heart and blood circulatory system more efficient
* Help reduce body fat, help to reach and stay at a healthy weight
* Help reduce emotional and mental stress, tension, anxiety, and depression
When the person already has CHD aerobic exercise prevents the blood vessels from narrowing further (anti-atherosclerotic), prevents blood clotting (anti-thrombotic), helps deliver blood to the heart (anti-ischaemic), and helps to maintain a normal heart rhythm (anti-arrhythmic), as decrease the risk of death from CHD.

## Recommendations

Because many lifestyle habits begin during childhood, parents should persuade their children to make healthy choices, to reaching a strengthen heart and cardiovascular system. Moreover, parents should encourage their children to maintain a healthy weight, to follow a healthy diet, to do physical activity regularly, particularly AEROBIC EXERCISE, and do not smoke to have a lower risk of CHD. If the children follow those recommendations until their adulthood, the risk of suffering CHD would be considerably lower compared with the adults who did not follow those instructions when they were children.
Australian Federal Government should increase the Governmental Politics against the developing and increasing the CHD amongst Australians, also it should be and increasing of advertising about of the CHD, in order to advice Australians how lethal is this disease; by doing that Australians would realise the terrible consequences to suffer CHD and they would know that when they have this disease they are in high risk of dying; as a result, most of the people would star follow the recommendations to avoid to have CHD.
Finally, to achieve maximum benefits, the person should gradually work up to an aerobic session of at least 30 continuous minutes, at least three to four times a week. With an intensity of 70 to 85 percent of maximal hate rate. Aerobic exercises include: walking, jogging, jumping rope, bicycling, skiing, skating, rowing, and aerobics, between others. The American Heart Association recommends exercising on most days of the week. While the more exercise the person can do the better for his/her fitness and his/her health, also reduces the risk to die due to CHD .

## Further reading

* [Exercising with Coronary Heart Disease http://www.acsm.org/access-public-information/articles/2012/01/19/exercising-with-coronary-heart-disease]
* [Exercise is Medicine Australia. Heart disease – coronary heart disease (CHD) – http://exerciseismedicine.org.au/wp-content/uploads/2011/07/CHD_full.pdf]
* [American Heart Association. Exercise and Cardiovascular Health: http://circ.ahajournals.org/content/107/1/e2.full.pdf+html]
* [Exercise for Persons with Cardiovascular Disease http://www.acsm.org/docs/current-comments/exercise-for-persons-with-cardiovascular-disease.pdf]
* [Exercise Prevents Heart Disease as Effectively as Expensive Medications http://fitness.mercola.com/sites/fitness/archive/2013/10/18/exercise-may-prevent-heart-disease.aspx]
* [Exercise for Patients with Coronary Artery Disease http://www.healthsystem.virginia.edu/pub/renal-services/exercise/position-stand-on-exercise-and-cad.pdf]
* Videos: [Coronary Heart Disease develops: http://www.youtube.com/watch?v=vUVljd0vweU], [Diabetes, Exercise and Your Risk for Coronary Artery Disease: http://www.youtube.com/watch?v=NlGvtf3rwGo]

## References

* 1 2 Nordqvist, C. (2013). 'What Is Coronary Heart Disease (Coronary Artery Disease)? What Causes Coronary Heart Disease? ', Journal of Medical News Today, viewed 26 October 2013, <http://www.medicalnewstoday.com/articles/184130.php>
* ↑ Dugdale, D. (2012). 'Coronary Heart Disease', Journal of National Institutes of Health, MedlinePlus, viewed 26 October 2013, <http://www.nlm.nih.gov/medlineplus/ency/article/007115.htm>
* ↑ Moholdt, T. (2010). 'Aerobic exercise in coronary heart disease', Doctoral thesis Norwegian University of Science and Technology. Faculty of Medicine, Department of Circulation and Medical Imaging.
* ↑ Heart Disease Facts America's Heart Disease Burden, Center for Disease Control and Prevention, viewed 26 October 2013, <http://www.cdc.gov/heartdisease/facts.htm>.
* ↑ Cardio Vascular Disease, Data and Statics, Heart Foundation, viewed 26 October 2013, <http://www.heartfoundation.org.au/information-for-professionals/data-and-statistics/Pages/default.aspx>
* ↑ Dugdale, D. (2012). 'Heart disease risk factors', Journal of National Institutes of Health, MedlinePlus, viewed 26 October 2013. <http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000106.htm>.
* ↑ Coronary artery disease, Risk factors, Mayo Clinic, viewed 26 October 2013, <http://www.mayoclinic.com/health/coronary-artery-disease/DS00064/DSECTION=risk-factors>
* ↑ Coronary heart disease – Prevention, Preventing Heart disease, National Health Service England, viewed 26 October 2013, < http://www.nhs.uk/Conditions/coronary-heart-disease/Pages/prevention.aspx>
* 1 2 3 Heart Disease: Exercise for a Healthy Heart, Heart Disease Health Center, WebMD Medical Reference, viewed 26 October 2013, <http://www.webmd.com/heart-disease/guide/exercise-healthy-heart>
* ↑ Myers, J. (2003). 'Cardiology Patient Page, Exercise and Cardiovascular Health', Journal of American Heart Association, 107: e2-e-5, doi:10.1161/0.1
* ↑ Wood, R.J., et al. (2012). ‘Heart disease–coronary heart disease CHD, (2011), Exercise is Medicine, viewed 26 October 2013, < http://exerciseismedicine.org.au/wp-content/uploads/2011/07/CHD_full.pdf>