Practical Tips for Staying Active with Angina

Adding some exercise to your daily routine can help you feel better if you have angina. Discover the benefits of exercise and how to do it safely.

What are the benefits of staying active with angina?^1-3 

Angina occurs when your heart is not getting an adequate supply of oxygen-rich blood. This could occur during exercise or even when you are walking up the stairs. However, if your angina is stable, exercise can improve your condition.  

Indeed, aerobic exercise helps strengthen the heart through exercise and increases your circulation of oxygen-rich blood to your heart during rest and activity. So regular exercise improves your body’s ability to take in and use oxygen, which means you can do daily activities more easily and feel less tired. It can also help reduce your angina symptoms, such as chest pain and shortness of breath by encouraging your body to use a network of tiny blood vessels that supply your heart. And exercise can also reduce the risk of your angina getting worse, and of a heart attack or stroke, as well as helping to manage your weight. 

Whatever your heart or circulatory condition, you will have something to gain from exercise, as staying active with angina could help to ease your symptoms, help you do more in your daily life, and stop your disease from getting worse. 

What type of exercise should I do for staying active with angina?^1,2 

Aerobic exercise 

Aerobic exercise is where you are moving your body’s largest muscles, such as the ones in your arms and legs, in a way that makes you warm and slightly out of breath. Aerobic exercise examples include walking, cycling, and swimming but also everyday activities such as doing housework, gardening, or playing with your children or grandchildren.

These types of activities help strengthen the heart through exercise. Your heart and circulatory system can work better, so you are more able to do daily tasks without getting tired or breathless. Aerobic exercise also lowers your risk of heart and circulatory diseases, and can help stop them getting worse by: 

• Lowering your resting blood pressure and heart rate 
• Improving your cholesterol levels 
• Helping you keep to a healthy weight, which in turn reduces your risk of developing type 2 diabetes 

It is recommended to do at least 150 minutes a week of moderate-intensity aerobic exercise. If you can not walk or find it difficult to balance, you can still do aerobic exercise by moving your arms and top half of your body. There are also specialized bikes such as handcycles and trikes. 

Resistance training 

Strengthening exercises, also called resistance training, are designed to make your muscles work harder. These could involve lifting weights or using resistance equipment such as bands or cables. You can also use your own body weight or start with moving from sitting to standing out of a chair, then progress to doing squats or press-ups against the wall. 

Strengthening our muscles means that your arms and legs will work better and that will take the demand off your heart. The stronger your muscles are, the easier you will find it to do aerobic exercises and everyday tasks without getting so breathless and tired. 

It is recommended to do strength training 2 to 3 days a week, ideally spread out across the week, so you have at least a day’s recovery time in between. Start with an exercise that you can repeat 10 to 12 times, with the last couple of repetitions starting to feel a bit challenging. 

Balance exercises and flexibility exercises 

Yoga, Pilates, and tai chi are examples of exercises that help improve your flexibility and balance. But you do not need to set aside big blocks of time to work on flexibility and balance. You could include stretches and balance exercises into your other exercise sessions. Indeed, flexibility exercises are best done when your muscles are already warm, so you can add on some stretches after you do aerobic exercise, such as after walking, for example. 

Balance exercises, which reduce the risk of you having falls, are where we move into a position that is less stable and get our body to hold the position. It could be something as simple as standing with one foot in front of the other. You could stand on one leg while holding something to support you, like a kitchen worktop, and then gradually try doing that without so much support. And flexibility exercises make sure muscles do not get too tight. This helps you to move more easily and avoid pain or injury. 

It is recommended to do balance and flexibility exercises 2 to 3 days a week. Try to hold muscle stretches for at least 30 seconds. 

How to exercise safely for staying active with angina?^1,3 

If you suffer from angina, you may be concerned that exercise will make your symptoms worse. Exercise is perfectly safe if it is done in the right way. Here are some practical tips to do so: 

• Talk to your doctor, before starting any type of exercise. Ask your doctor if regular physical activity is safe and appropriate for you. Ask what types of exercise are best for you. Should you focus on low impact activities? Or can you do more moderate or high intensity exercises? Ask about what signs and symptoms are dangerous.
• Track your heart rate during exercise, to give you an idea of how hard your heart is working. When you first start an exercise program after being diagnosed with angina, it is typically recommended to do low impact activities that keep your heart rate at about 50% of your maximum heart rate, which is 220 subtracted from your age. If cleared by your doctor, you can slowly build up your aerobic endurance and increase to 60% or 70% of your maximum heart rate. 
• Start with short bouts of low impact activities. If you are trying to recover and strengthen the heart through exercise, it is recommended to start with short bouts of lower intensity exercises. Restarting with higher intensity exercises or trying to go for a longer period could cause symptoms to reoccur or for your condition to get worse. Aim to start with just 15-20 minutes of low impact activities each day. If this feels too easy, increase the time to 25-30 minutes the next day, but do not increase the intensity. Choose exercises that are low in intensity such as walking, water walking, cycling, or using the elliptical.   
• Always include an extended warm-up and cool-down, essential to safe exercise.
  Slowly easing into and out of an exercise routine helps slowly increase your heart rate, blood flow, and warm up your muscles. If you do not, you can overwork your heart too quickly which could cause an onset of symptoms. Start with a minimum of a 10-minute warm-up. Include very low intensity aerobic exercises and light stretching. Your cool-down should also be 10 minutes of low intensity aerobic exercise followed by some light stretching, until your breathing and heart rate return to normal. 
  
• Avoid exercising outdoors in extreme weather conditions, such as very cold, hot, or humid weather conditions. Being active in these types of weather increase your risk for experiencing a cardiac event.
• Start by aiming for 150 minutes of aerobic cardio each week and slowly add in low intensity strength training. 
• Include more lifestyle activity, such as walking to get the mail, taking the stairs, gardening, mowing the lawn or sweeping the floor, to elevate your heart rate mildly enough that you can still see aerobic benefits.  
• Always include 1 or 2 regular rest days each week. Rest is important for those suffering from angina because you need to allow your heart and cardiovascular system to rest and recover in between workouts. 
• Stop immediately if you experience any type of chest pain, difficulty breathing or tightness in the chest. After you discontinue your exercise, keep your heart rate level low. Do not restart exercise even after the pain or other discomfort has subsided and take a rest day. If you notice any pain or discomfort the following day or at your next exercise session, contact your doctor immediately. 
• Always carry your medications with you, such as nitrogen glycerin. It is to be taken when you start to experience any symptoms. This is why it is essential to always have on you. Also, make sure that others know of your condition and where your medication is. If you were to have any symptoms and could not get to your medications, someone else should be able to help you. 
• Do not exercise when you are getting angina symptoms, or if you have symptoms at rest.