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    Exercise Good for the Heart, Even After a Heart Attack.

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    People with heart disease begin with a walking program that builds up gradually, and they ride stationary bikes and use treadmills, Belmont says. But, she adds, it's important to do upper body exercises to strengthen these areas because arm and upper body movements actually are more taxing on the heart.

    "Someone who has been smoking and sedentary all their life will take longer to recover than a farmer who has been walking and doing physical work all his life," Belmont says. "A person who's been conditioned will recover faster. This has to be an aggressive risk management program, not just an exercise program."

    According to a 1995 study published in the Journal of the American Medical Association,cardiac patients who were sedentary before the heart attack then become active have a better chance of survival than those who never exercised or stopped after their cardiac event.

    In the Corpus Christi Heart Project, Steffen-Batey, who is now an epidemiologist at the University of Minnesota School of Public Health, and her colleagues studied more than 400 Mexican-American and Caucasian men and women for a period of two to seven years after their first heart attacks. They analyzed leisure time physical activity, measured increases and decreases in activity, and classified the types of activities.

    The researchers found that even those who had been active before a heart attack but decreased their exercise level afterward had a 51% lower risk of death than those who were always sedentary. Risk of second heart attack remained about the same for these patients. The researchers speculate that this was a residual effect from benefits gained from pre-event activity.

    Results of the study showed no differences based on gender or race.

    Steffen-Batey recommends that physical activity be an integral part of heart disease prevention for everyone. However, she emphasizes that exercise should be under the guidance of a doctor.

    In addition, Belmont reminds that exercise won't help unless the patient modifies other risk factors.

    "We have some patients who are diabetic, not taking their medications, not eating properly, and smoking," she says. "Exercise is one part of rehabilitation, and it's vital, but it's not the only factor.

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