# Exercise as it relates to Disease/High intensity interval training: in coronary heart disease following a stent treatment
### WHAT IS CORONARY HEART DISEASE?

Coronary heart disease (CHD) is a narrowing of small blood vessels that supply oxygenated blood and nutrients to the heart. CHD is also known as coronary artery disease. The most common causes by far is the increased risk of developing atherosclerosis (blocked artery) in those who smoke, have high blood pressure, high cholesterol level, lack of exercise and diabetes. The condition is caused by build-up of fat products in the arteries around the heart that leads the chronic abnormality into coronary artery disease. It narrows the blood vessels which is essential to provide oxygen and blood-flow to the heart.

### SYMPTOMS OF CORONARY HEART DISEASE

Coronary artery disease is the cause to heart abnormality that affects many individuals in Australia and worldwide. Diagnosis, and treatment as well as the rehabilitation are very important to undertake to change the life quality and increase the life of cardiac individuals. Symptoms can be noticeable, however, in early stages of heart disease, a person can have the disease but without symptom. Common symptoms include:
* Angina (chest pain-leads to shoulder, arms, neck and back)
* Shortness of breath
* Fatigue whilst performing activity
Older people, 65+, women and diabetic groups are at higher of noticing these symptoms other than chest pain, but can cause fatigue, shortness of breath, general weakness.

## TREATMENT
### CORONARY STENT

Stents and surgeries are common treatments for heart diseases. Coronary stent are tiny, and an expandable mesh tube that keeps the arteries open in treatment of heart disease to supply blood to heart. It is used normally used in a clinical procedure known as percutaneous coronary intervention (PCI. For many people, coronary artery disease treatment improves blood flow through what was the blocked artery. This results as less chest pain with greater capacity when performing exercising.
Primarily, lifestyle changes prevent the inception of CHD/CAD, which is under take exercise, with diet changes, in particular fat sources. A therapeutic lifestyle is a program that is used for a guideline
Some of the benefits of exercising after stent treatment:
* Strengthen the heart and cardiovascular system
* Keep cholesterol at a healthy level (low LDL and high HDL)
* Improve the circulation
* Rapid heart recovery
* Increases fitness
* reduces blood pressure
* Improving coronary Artery Vasomotion
* Make heart and blood circulatory system more efficient
* helps the heart functionality to stay well

## EXERCISE BASED
### HIGH INTENSITY INTERVAL TRAINING EXERCISE

Interval training can be used as a suitable exercise program as a rehabilitation source to reduce the symptoms of the disease and reduce any complications. High intensity interval training (HIIT) involves repeats of high intensity exercises that lasts up to 30 seconds to several minutes, with 1–5 minutes of recovery period (no exercise or very low intensity) in between sets. It is in the form of aerobic exercise that consists of short periods of high to low intensity exercise; it is safe and more effective than usual moderate intensity constant training for improving the aerobic capacity.
High intensity interval training has been shown to significantly reduce subcutaneous fat, particularly abdominal fat as well as total body mass and to improve VO2 max (a marker of physical fitness) and insulin sensitivity. Winggate protocol developed in 1970s, is an example of HIIT involves 30 seconds of cycling at maximum effort, at 90% intensity of of vo2 max with 4 minutes of recovery, repeated 4-6 times per session, 3 times a week. This results in 2–3 minutes of exercise at max intensity with 15–25 minutes of low intensity exercise which makes it time efficient method of exercise.

## RECOMMENDATION

Physical activity and exercising is a recognized intervention for both primary secondary prevention of coronary heart disease. It is important to consider factors prior to exercise with appropriate direction and structured training plan. With respect to mode, frequency, duration, intensity and progression of exercise, these include:
* resistance training
* walking
* running
* swimming
* cycling
Exercises can be performed through format of 2 x 4 Minute intervals, 3–5 days a week at 90% of maximum Heart Rate, followed with 2-3 minute of recovery at 70% heart rate, with duration of exercising of 20–60 minutes (reference)

## FURTHER INFORMATION

* Videos: [Coronary Heart Disease develops: http://www.youtube.com/watch?v=vUVljd0vweU] [ High Intensity Interval training: https://www.youtube.com/watch?v=FPtL5NJM--A]
The Heart Foundation
http://www.heartfoundation.org.au
Exercise Information:
* ACSM Exercise Recommendations for Prevention and Treatment of CHD

## References

* ↑ 1.Nordqvist, C. (2013). 'What Is Coronary Heart Disease (Coronary Artery Disease)? What Causes Coronary Heart Disease? ', Journal of Medical News Today, <http://www.medicalnewstoday.com/articles/184130.php>
* ↑ Heart disease – coronary heart disease (CHD). (2014). 1st ed. [ebook] p.All. Available at: http://exerciseismedicine.org.au/wp-content/uploads/2011/07/CHD_full.pdf
* ↑ Heart disease – coronary heart disease (CHD). (2014). 1st ed. [ebook] p.All. Available at: http://exerciseismedicine.org.au/wp-content/uploads/2011/07/CHD_full.pdf
* ↑ http://www.nlm.nih.gov/medlineplus/ency/article/007115.htm
* ↑ Nordqvist, C. (2013). 'What Is Coronary Heart Disease (Coronary Artery Disease)? What Causes Coronary Heart Disease? ', Journal of Medical News Today, http://www.medicalnewstoday.com/articles/184130.php
* ↑ Myers, J. (2003). 'Cardiology Patient Page, Exercise and Cardiovascular Health', Journal of American Heart Association, 107: e2-e-5, doi:10.1161/0.1
* ↑ 9. Rognmo, O. et al (2004). High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. European Journal of Cardiovascular Prevention and Rehabilitation. 11(3):216-22
* ↑ 10. Warburton DE, McKenzie DC, Haykowsky MJ, et al: Effectiveness of high-intensity interval training for the rehabilitation of patients with coronary artery disease. Am J Cardiol 2005;95:1080–4
* ↑ Gibala MJ, McGee SL. Metabolic adaptations to short-term high-intensity interval training: a little pain for a lot of gain? Exerc Sport Sci Rev 2008;36:58–63
* ↑ Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes 2011;2011:868305.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991639/
* ↑ Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes 2011;2011:868305
* ↑ Helgerud J, Hoydal K, Wang E, et al. Aerobic high-intensity intervals improve VO2max more than moderate training. Med Sci Sports Exerc 2007;39:665–71.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777731/
* ↑ Bar-Or O, Dotan R, Inbar O. A 30 seconds all out ergometric test: its reliability and validity for anaerobic capacity. Israel Journal of Medical Science 1977;113:226–30
* ↑ Gibala MJ, McGee SL. Metabolic adaptations to short-term high-intensity interval training: a little pain for a lot of gain? Exerc Sport Sci Rev 2008;36:58–63. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381816/
* ↑ Tjonna, A. E. et al (2008) Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Department of Circulation and Medical Imaging. 22;118(4):346-54. http://www.ncbi.nlm.nih.gov/pubmed/18606913