Weight lifting damages the heart, cardiologist said
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coccodrillo72
Posts: 94 Member
Yes, he did really say that. Actually, it was two of them, and they were singing more or less the same song.
But let me step back, so that I can give the whole picture: three weeks ago I had heart surgery, more precisely "Transcatheter ablation for atrial fibrillation". It's not open heart surgery but still not a walk in the park, let me tell you. During the last three years I have been having increasingly frequent episodes of atrial fibrillation so my choice was between medication (with side effects) for the rest of my life and surgery - which has an 80% chance of success. I chose surgery. It's still eary to tell if the atrial fibrillation is cured, only time will tell.
But back to strenght training. After the surgery I asked one of the cardiologists on staff WHEN I would have been able to resume weight lifting (I was doing stronglifts 5x5 up until the operation) and he said that I couldn't, vaguely suggesting that it was not for me. So I asked another cardiologist, who firmly replied: "NEVER!", and then went on telling me that weight lifting may damage the heart, not just MY heart, but ANY heart, and that should be avoided.
That gave me pause. I do not want to blindly accept that answer, but it wouldn't be smart to dismiss such a strong statement, knowing that those cardiologists are surely not incompetent - one of them is on staff in a world renowned heart center.
So I did a little research and found a few articles, but mainly a 2007 statement by the American Heart Association about "Resistance Exercise in Individuals With and Without Cardiovascular Disease".
I'll highlight a few keypoints below but I'd like to know if anyone has more data and/or science based contributions on this topic, that I think it's of paramount importance for everyone who strenght train, with or without heart complications.
A side note: this little adventure of mine showed me the importance of establishing positive habits. When your daily life changes dramatically it's easier to rely on strong habits than on willpower. So I was able to keep logging my meals even when I was stuck on my hospital bed and to resume walking (well, limping is a more accurate description) a few hours after the surgery.
TL;DR: Resistance Training (RT) has many potential benefits even for people with CVD (cardiovascular disease). Excessive BP (blood pressure) elevations have been documented with high-intensity RT (80% to 100% of 1-RM) but such elevations are generally not a concern with low- to moderate-intensity RT performed with correct breathing technique and avoidance of the Valsalva manuever (holding your breath while lifting).
Resistance Exercise in Individuals With and Without Cardiovascular Disease: 2007 Update. A Scientific Statement From the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism
http://circ.ahajournals.org/content/early/2007/07/16/CIRCULATIONAHA.107.185214.citation
From the abstract: "Prescribed and supervised resistance training (RT) enhances muscular strength and endurance, functional
capacity and independence, and quality of life while reducing disability in persons with and without cardiovascular
disease."
So far so good. Then as far as RT is concerned a distinction is made between static (isometric) exercise (no movement of the limb) and Dynamic (isotonic) exercise, which causes movement of the limb.
"During isometric exercise, increases in HR (heart rate) and both SBP (systolic blood pressure) and DBP (diastolic blood pressure) are nearly proportional to the force exerted relative to the greatest possible force that an individual can evoke (percent maximum voluntary contraction [MVC]) rather than the absolute tension developed."
"The combination of vasoconstriction and increased cardiac output results in a disproportionate rise in SBP, DBP, mean BP, and peripheral vascular resistance. These pressures continue to rise throughout the duration of the exercise. Thus, a significant pressure load is imposed on the cardiovascular system, presumably to increase perfusion to the contracting skeletal muscle."
"The impact of the Valsalva maneuver (a forced expiration is invoked against a closed glottis, holding your breath while lifting) and high levels of muscle tension to lift or otherwise move a heavy weight can result in somewhat dramatic changes to the physiological responses to RT. Depending on the duration and intensity of the maneuver and the resistance, an increase in intrathoracic pressure leading to decreased venous return and potentially reduced cardiac output may occur. The physiological responses are an increase in HR to maintain cardiac output and vasoconstriction to maintain BP, which otherwise may decrease with decreasing cardiac output. At the release of the “strain,” venous return is dramatically increased, increasing cardiac output, which is now circulating through a somewhat constricted arterial vascular system. The result is a rise in BP, potentially quite dramatic, that may require minutes to return to baseline."
Now for dynamic (isotonic) exercise there is a: "[...] combined volume and pressure load. The level of the developed pressure load depends on the magnitude of the resistance (percent MVC) required and the duration of the muscle contraction in relation to the intervening rest period. Thus, a smaller pressure load on the cardiovascular system will occur during this type of exercise if the relative resistance is not too great, the contraction period is relatively short (1 to 3 seconds), and there is at least a 1- to 2-second rest period between contractions. The magnitude of the volume load on the cardiovascular system during a dynamic-resistance exercise will be greater when the magnitude of the resistance is relatively low (able to complete 20 to 30 repetitions) and the contractions are performed every few seconds. Specifically, and again depending on the duration and intensity of the resistance exercise, HR can substantially increase and may approach age-predicted maximum, that is, HR achieved with treadmill exercise testing. Blood pressure responses, both systolic and diastolic, may potentially surpass values achieved during standard exercise testing."
"The effects of RT on the cardiovascular system have been studied in individuals with and without CVD and have been summarized in several reviews. The results represent a consensus of findings in which the lack of unanimity is attributable to multiple factors, including specific type, intensity, and duration of RT."
"Studies of cardiac morphology and function have consistently shown that the alterations associated with RT are physiological, although certain cardiac effects exist on a continuum between normal and pathological. Intensive RT characteristically increases left ventricular (LV) wall thickness and mass, with little or no change in LV diameter. Although statistically significant, the increase in wall thickness is modest, and values are generally in the upper range of untrained, normal subjects."
Safety of RT
"Both research findings and clinical experience indicate that resistance exercise is relatively safe. [...] Although excessive BP elevations have been documented with high-intensity RT, for example, 80% to 100% of 1-RM performed to exhaustion, such elevations are generally not a concern with low- to moderate-intensity RT performed with correct breathing technique and avoidance of the Valsalva manuever."
"The use of resistance testing and training in moderate- to high-risk cardiac patients requires good clinical judgment and close monitoring. Studies in healthy adults and low-risk cardiac patients, that is, persons without resting or exercise-induced evidence of myocardial ischemia, severe LV dysfunction, or complex ventricular dysrhythmias, have reported no major adverse cardiovascular events. RT also appears to be safe among patients with controlled hypertension, and intra-arterial BPs during weight lifting in cardiac patients are reported to be within a clinically acceptable range at 40% and 60% of 1-RM."
"The application of RT in the rehabilitation of patients with CHD has been reviewed. [...] The absence of anginal symptoms, ischemic ST-segment depression, abnormal hemodynamics, complex ventricular dysrhythmias, and cardiovascular complications suggests that strength testing and training are safe for clinically stable men with CHD who are actively participating in a supervised rehabilitation program."
"Vigorous or high-intensity RT should not be initiated for persons without prior exposure to more moderate resistance exercise independently of age, health status, or fitness level. "
Absolute and Relative Contraindications to Resistance Training
Absolute:
Unstable CHD
Decompensated HF
Uncontrolled arrhythmias
Severe pulmonary hypertension (mean pulmonary arterial pressure >55 mm Hg)
Severe and symptomatic aortic stenosis
Acute myocarditis, endocarditis, or pericarditis
Uncontrolled hypertension (>180/110 mm Hg)
Aortic dissection
Marfan syndrome
High-intensity RT (80% to 100% of 1-RM) in patients with active proliferative retinopathy or moderate or worse nonproliferative diabetic retinopathy
Relative (should consult a physician before participation):
Major risk factors for CHD
Diabetes at any age
Uncontrolled hypertension (>160/>100 mm Hg)
Low functional capacity (<4 METs)
Musculoskeletal limitations
Individuals who have implanted pacemakers or defibrillators
But let me step back, so that I can give the whole picture: three weeks ago I had heart surgery, more precisely "Transcatheter ablation for atrial fibrillation". It's not open heart surgery but still not a walk in the park, let me tell you. During the last three years I have been having increasingly frequent episodes of atrial fibrillation so my choice was between medication (with side effects) for the rest of my life and surgery - which has an 80% chance of success. I chose surgery. It's still eary to tell if the atrial fibrillation is cured, only time will tell.
But back to strenght training. After the surgery I asked one of the cardiologists on staff WHEN I would have been able to resume weight lifting (I was doing stronglifts 5x5 up until the operation) and he said that I couldn't, vaguely suggesting that it was not for me. So I asked another cardiologist, who firmly replied: "NEVER!", and then went on telling me that weight lifting may damage the heart, not just MY heart, but ANY heart, and that should be avoided.
That gave me pause. I do not want to blindly accept that answer, but it wouldn't be smart to dismiss such a strong statement, knowing that those cardiologists are surely not incompetent - one of them is on staff in a world renowned heart center.
So I did a little research and found a few articles, but mainly a 2007 statement by the American Heart Association about "Resistance Exercise in Individuals With and Without Cardiovascular Disease".
I'll highlight a few keypoints below but I'd like to know if anyone has more data and/or science based contributions on this topic, that I think it's of paramount importance for everyone who strenght train, with or without heart complications.
A side note: this little adventure of mine showed me the importance of establishing positive habits. When your daily life changes dramatically it's easier to rely on strong habits than on willpower. So I was able to keep logging my meals even when I was stuck on my hospital bed and to resume walking (well, limping is a more accurate description) a few hours after the surgery.
TL;DR: Resistance Training (RT) has many potential benefits even for people with CVD (cardiovascular disease). Excessive BP (blood pressure) elevations have been documented with high-intensity RT (80% to 100% of 1-RM) but such elevations are generally not a concern with low- to moderate-intensity RT performed with correct breathing technique and avoidance of the Valsalva manuever (holding your breath while lifting).
Resistance Exercise in Individuals With and Without Cardiovascular Disease: 2007 Update. A Scientific Statement From the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism
http://circ.ahajournals.org/content/early/2007/07/16/CIRCULATIONAHA.107.185214.citation
From the abstract: "Prescribed and supervised resistance training (RT) enhances muscular strength and endurance, functional
capacity and independence, and quality of life while reducing disability in persons with and without cardiovascular
disease."
So far so good. Then as far as RT is concerned a distinction is made between static (isometric) exercise (no movement of the limb) and Dynamic (isotonic) exercise, which causes movement of the limb.
"During isometric exercise, increases in HR (heart rate) and both SBP (systolic blood pressure) and DBP (diastolic blood pressure) are nearly proportional to the force exerted relative to the greatest possible force that an individual can evoke (percent maximum voluntary contraction [MVC]) rather than the absolute tension developed."
"The combination of vasoconstriction and increased cardiac output results in a disproportionate rise in SBP, DBP, mean BP, and peripheral vascular resistance. These pressures continue to rise throughout the duration of the exercise. Thus, a significant pressure load is imposed on the cardiovascular system, presumably to increase perfusion to the contracting skeletal muscle."
"The impact of the Valsalva maneuver (a forced expiration is invoked against a closed glottis, holding your breath while lifting) and high levels of muscle tension to lift or otherwise move a heavy weight can result in somewhat dramatic changes to the physiological responses to RT. Depending on the duration and intensity of the maneuver and the resistance, an increase in intrathoracic pressure leading to decreased venous return and potentially reduced cardiac output may occur. The physiological responses are an increase in HR to maintain cardiac output and vasoconstriction to maintain BP, which otherwise may decrease with decreasing cardiac output. At the release of the “strain,” venous return is dramatically increased, increasing cardiac output, which is now circulating through a somewhat constricted arterial vascular system. The result is a rise in BP, potentially quite dramatic, that may require minutes to return to baseline."
Now for dynamic (isotonic) exercise there is a: "[...] combined volume and pressure load. The level of the developed pressure load depends on the magnitude of the resistance (percent MVC) required and the duration of the muscle contraction in relation to the intervening rest period. Thus, a smaller pressure load on the cardiovascular system will occur during this type of exercise if the relative resistance is not too great, the contraction period is relatively short (1 to 3 seconds), and there is at least a 1- to 2-second rest period between contractions. The magnitude of the volume load on the cardiovascular system during a dynamic-resistance exercise will be greater when the magnitude of the resistance is relatively low (able to complete 20 to 30 repetitions) and the contractions are performed every few seconds. Specifically, and again depending on the duration and intensity of the resistance exercise, HR can substantially increase and may approach age-predicted maximum, that is, HR achieved with treadmill exercise testing. Blood pressure responses, both systolic and diastolic, may potentially surpass values achieved during standard exercise testing."
"The effects of RT on the cardiovascular system have been studied in individuals with and without CVD and have been summarized in several reviews. The results represent a consensus of findings in which the lack of unanimity is attributable to multiple factors, including specific type, intensity, and duration of RT."
"Studies of cardiac morphology and function have consistently shown that the alterations associated with RT are physiological, although certain cardiac effects exist on a continuum between normal and pathological. Intensive RT characteristically increases left ventricular (LV) wall thickness and mass, with little or no change in LV diameter. Although statistically significant, the increase in wall thickness is modest, and values are generally in the upper range of untrained, normal subjects."
Safety of RT
"Both research findings and clinical experience indicate that resistance exercise is relatively safe. [...] Although excessive BP elevations have been documented with high-intensity RT, for example, 80% to 100% of 1-RM performed to exhaustion, such elevations are generally not a concern with low- to moderate-intensity RT performed with correct breathing technique and avoidance of the Valsalva manuever."
"The use of resistance testing and training in moderate- to high-risk cardiac patients requires good clinical judgment and close monitoring. Studies in healthy adults and low-risk cardiac patients, that is, persons without resting or exercise-induced evidence of myocardial ischemia, severe LV dysfunction, or complex ventricular dysrhythmias, have reported no major adverse cardiovascular events. RT also appears to be safe among patients with controlled hypertension, and intra-arterial BPs during weight lifting in cardiac patients are reported to be within a clinically acceptable range at 40% and 60% of 1-RM."
"The application of RT in the rehabilitation of patients with CHD has been reviewed. [...] The absence of anginal symptoms, ischemic ST-segment depression, abnormal hemodynamics, complex ventricular dysrhythmias, and cardiovascular complications suggests that strength testing and training are safe for clinically stable men with CHD who are actively participating in a supervised rehabilitation program."
"Vigorous or high-intensity RT should not be initiated for persons without prior exposure to more moderate resistance exercise independently of age, health status, or fitness level. "
Absolute and Relative Contraindications to Resistance Training
Absolute:
Unstable CHD
Decompensated HF
Uncontrolled arrhythmias
Severe pulmonary hypertension (mean pulmonary arterial pressure >55 mm Hg)
Severe and symptomatic aortic stenosis
Acute myocarditis, endocarditis, or pericarditis
Uncontrolled hypertension (>180/110 mm Hg)
Aortic dissection
Marfan syndrome
High-intensity RT (80% to 100% of 1-RM) in patients with active proliferative retinopathy or moderate or worse nonproliferative diabetic retinopathy
Relative (should consult a physician before participation):
Major risk factors for CHD
Diabetes at any age
Uncontrolled hypertension (>160/>100 mm Hg)
Low functional capacity (<4 METs)
Musculoskeletal limitations
Individuals who have implanted pacemakers or defibrillators
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Replies
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No big surprises, but great info. thanks0
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I guess I'm screwed then.0
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I'll take my chances0
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wonder how the hearts of the group that sat on their *kitten* thier whole life looked like0
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So two guys vs. every other health expert out there. Sounds like a great reason for me to stop lifting, and just take raspberry ketones to ensure my health.0
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Yeah well could you tell them that since taking up weight training I have been taken off both beta-blockers and blood pressure medication, also my resting heart rate used to be between 109-145bpm now it sits between 53-60bpm I also used to suffer from hypertension with a blood pressure that was bordering on killing me, now it is 120/80.
I read the info but is hard for me to verify as a layman but I think I got the gist.
As with all exercise it is best to proceed with caution and intelligence.
Good thread.0 -
bump0
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Everything has risk.... including waking up in the morning. I will take my chances!0
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meh.0
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Correct me if I'm wrong but this evidence suggests that resistance training spikes blood pressure.
Is there actually any evidence to suggest that it is implicated in causing damage to heart leading to clinical illness?0 -
wonder how the hearts of the group that sat on their *kitten* thier whole life looked like
EXACTLY.0 -
Hmmm... Interesting. They are referring to physiological responses to lifting, but it seems a bit dramatized. It's like saying that if you squat, since your muscles are contracted, you'll get cramps because your blood vessels are also going to contract. It doesn't work that way though. They are talking about how the BP increases, but even cardiovascular exercises do this, and even more. It's just a temporary thing that comes with any exercise that accelerates your heart rate. When you are going to have your BP measured your physician suggests that you do so at a moment that you are relaxed, and have not performed any sort of exercise prior to this, they don't suggest that you DON'T exercise at all, because everyone is aware that it increases your heart rate, but it doesn't mean that it's bad for you as long as you do so in a safe way (correct form, etc.).
I'm sure many of the people who lift will beg to differ.
IDK LOL.0 -
I had cardiac ablation for Supraventricular Tachycardia and my doctor never ever said anything like that! I would think that unless you have high blood pressure there would be no issues with ST.
Give the surgery a month before you can tell if it worked. My heart fluttered about like mad for a month and I thought he made it worse! I went on to lose 30 pounds after my surgery and I'm still here!0 -
oh well.
i'd rather die doing what i love than be a scared sedentary bag of mush.0 -
I just read something yesterday about how too much running will kill you and make your **** fall off (if you have one).
Okay, I'm exaggerating... slightly.
Let's see. I'm in my early 40's. Been running for about 20 years now and lifting weights for a good 18 years.
Hmmm... I guess I should be pricing out coffins?
At least my corpse will look fabulous.0 -
Yeah well could you tell them that since taking up weight training I have been taken off both beta-blockers and blood pressure medication, also my resting heart rate used to be between 109-145bpm now it sits between 53-60bpm I also used to suffer from hypertension with a blood pressure that was bordering on killing me, now it is 120/80.
I read the info but is hard for me to verify as a layman but I think I got the gist.
As with all exercise it is best to proceed with caution and intelligence.
Good thread.
"As with all exercise it is best to proceed with caution and intelligence" - I see a hypertension specialist and he cautioned me on significant weight training until I got my BP under control through cardio. He lectures around the world and has published several peer reviewed studies, so I took him at his word. After about a year, I didn't lose much weight, but my BP came down. He lowered me medicine and cleared me for moderate weight lifting and continued cardio. About a year ago, I go below obese BFI and he dropped my BP medicine to a maintenance mode (mine is likely genetic) and cleared me for normal weight lifting (i.e. not competitive) and rigorous cardio routine.
Moral of the story - if you trust your doctor, work with you doctor. If you don't trust your doctor, fire him/her and get a new one. I've done it before and it saved my life. Even wrote a bog about it.
But the key is proper, qualified medical supervision if you have any doubts. And agree - good thread.0 -
Food can be bad for your heart.
Walking down the street can be bad for your life.
Riding an airplane can be bad.
Sorry but I'm sure the benefits outweigh the tiny risk of it damaging.
If you live your life scared to do things you may love, you might as well just stay home in a fetal position.0 -
"Both research findings and clinical experience indicate that resistance exercise is relatively safe. [...] Although excessive BP elevations have been documented with high-intensity RT, for example, 80% to 100% of 1-RM performed to exhaustion, such elevations are generally not a concern with low- to moderate-intensity RT performed with correct breathing technique and avoidance of the Valsalva manuever."
"The use of resistance testing and training in moderate- to high-risk cardiac patients requires good clinical judgment and close monitoring. Studies in healthy adults and low-risk cardiac patients, that is, persons without resting or exercise-induced evidence of myocardial ischemia, severe LV dysfunction, or complex ventricular dysrhythmias, have reported no major adverse cardiovascular events. RT also appears to be safe among patients with controlled hypertension, and intra-arterial BPs during weight lifting in cardiac patients are reported to be within a clinically acceptable range at 40% and 60% of 1-RM."
Baiting subject line is baiting.0 -
QFToh well.
i'd rather die doing what i love than be a scared sedentary bag of mush.
Also don't die, we loves you
0
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