I am 59 years old and suffer from angina, for which I am on medication. My doctor advised me to take more exercise, so I go to the gym once a week but as soon as my heart rate gets to around 100 the angina pains start. I don’t feel any better, have not lost any weight and cannot see that it is going to help. Should I push myself harder?
Your doctor is right to encourage you to exercise more: losing excess weight and becoming more active can help ease your angina and protect your heart long-term. But as you are no doubt aware, angina is a form of heart disease and can, if you are not careful, trigger other life-threatening heart disturbances. So you need to be patient, determined and disciplined about doing exercise, and you need expert advice to start you off at the right level.
For anyone with angina it can be hard to believe that exercise can do you good, because the extra cardiovascular effort is exactly what sets off the chest pains in the first place (along with other common triggers such as big temperature changes and high stress). A proper exercise programme, though, will enable you very gradually to improve your heart’s efficiency, so you’ll be able to sustain more activity for a longer time without bringing on the angina pain.
Pick up the phone and ask your gym to make you an appointment with a properly qualified “REPS Level 3 exercise referral” instructor. This is an advanced qualification (sometimes called “GP referral”) and all instructors who have it should be competent to set you up with the right exercise programme for your specific needs. If your gym has no one with that qualification, leave and go to another gym or ask your GP about local exercise referral schemes.
It is important that you don’t bring on the angina pain while you exercise, which may mean starting very gently indeed. Rather than worrying about pushing yourself harder, try to think of ways of doing more frequent low-level exercise. Once a week is definitely not enough: aim to do some activity on at least three to four days a week.
That need not mean four days in the gym: walking a few bus-stops on the way to work or a short early-morning or early-evening walk will all count. The key is little and often, building up gradually, and always staying within safe, pain-free levels of exertion. Your exercise instructor will teach you how to monitor the right level; you may not be able to use your heart rate as a guide, because many angina medications (such as beta blockers) alter your baseline heart rate. Be sure to have your angina relief medication with you whenever you exercise.
Set yourself some mini-goals and think long-term: you should expect to be feeling better, more active and energetic within six months. If you are serious about losing weight, get some diet advice, too, because you cannot rely on activity alone to shed the extra pounds.