31st March 2016
Smoking, stress, alcohol consumption, dietary indiscretions, plus certain degenerative diseases such as elevated blood pressure and blood lipid levels, metabolic syndrome, cardiovascular disease including atherosclerosis and congenital issues such as problems with the heart’s electrical system, mean the 50+ athlete may find themselves in a different and more challenging, physiological situation than the 20-30 year old competitor lining up next to them at the starting line.
In order to improve CV health and reduce risk of an unwanted cardiac event follow this checklist.
- Get a personalised program designed based on a recent fitness test and don’t leave it until 2 weeks prior to the event. Read the SSC 50+ Endurance article for Human Race for more details.
- Watch your alcohol intake. Current guidelines are 14 units a week. That is 6 pints of 4% beer or 6 175ml glasses of wine. Reduce sugar intake. Eat fresh whole food. The best ‘health-food’ shop is your local greengrocer not somewhere selling Chia Seeds in a bar with a sell by date 1 year hence. Read the SSC 50+ Nutrition article for Human Race for more details.
- BLOOD PRESSURE. At present your blood pressure tested in a clinical environment ought to be below 140/90. If your blood pressure is at this level or above then you are Hypertensive and you may require medication to bring these figures down. Incidentally these figures may soon be reviewed and could be lowered bringing many thousands more adults into a new hypertensive range. Personally I would be much happier with a reading around 120/70 and I would attempt, through lifestyle change, to meet that figure.
- BLOOD CHOLESTEROL. The ratio of ‘good’ High Density Lipoproteins (HDL) to ‘bad’ Low Density Lipoproteins (LDL) is important here and a sensible exercise program can increase circulating levels of HDL. Your local NHS practice can check this.
- AVOID COMBINING THE 4 ‘E’s. This is very, very important and something that your trainer/pilates instructor/spin teacher may be unaware of. The 4 ‘E’s are:
- Extreme temperature
- Emotional stress
THE 4 E’s We have approximately 5.5 litre of blood in our body. During exercise the sympathetic nervous system is responsible for controlling the redistribution of blood from less active tissues, e.g. the gastrointestinal tract, to more active tissues i.e. skeletal muscle. During rest only about 15-20% of cardiac output goes to skeletal muscle but, at maximum exercise, active muscles receive 80-85% of cardiac output. This redistribution is accomplished primarily at the expense of reduced blood flow to the kidneys, liver, stomach and intestines as a result of local regulation of blood flow.
The ‘human machine’ is only 20% efficient i.e. during exercise the external work performed only accounts for 20% of the energy expended. The remainder appears as heat. Consequently, during prolonged exercise, or in a hot humid environment, heat builds up in the body and has to be dissipated. Under these circumstances blood is redirected to the skin to promote heat loss and blood volume is reduced due to sweating. The combination of the redistribution of blood to the skin and reduced blood volume means that venous return is diminished, this leads to reduced cardiac output and a consequent increase in heart rate (cardiovascular drift) and a rise in myocardial workload.
During periods of emotional stress there is a change in our blood lipid profile including a rise in triglyceride levels, a rise in LDL, a drop in HDL and a consequent increase in the likelihood of fatty plaques being laid down in the arteries and in clot formation.
Consider a 50+ sportive competitor who has:
- not trained properly for the event;
- suffered elevated stress levels, either at work or home or both;
- eaten inappropriately before a race i.e. too close to the start;
- high temperature from physical activity without replacing lost body fluids;
- started too hard, too fast thereby not distributing blood efficiently.
This is someone who now has a much greater risk of suffering a life changing, catastrophic event and all for no benefit and each pitfall could be easily avoided. Do not combine the 4 ‘E’s as this will place unnecessarily high demands on the heart muscle, the myocardium, which may in turn induce cardiac arrest.
Many senior health care professionals recommend that an emergency dose of 300mg soluble aspirin is carried at all times by people over the age of 50.
“Every year almost a quarter of a million people suffer heart attacks in Britain and a third die before reaching hospital”
British Heart Foundation 2007 Heart Disease Statistics
I highly recommend having 300mg Aspirin close to hand. Aspirin delivered to someone suffering from a lack of oxygen to the heart muscle may affect the circulation in such a way that blood can sufficiently perfuse the heart muscle thus buying time for medical help to arrive.
Visit http://www.aspod.co.uk/ for a comprehensive explanation and essential lifesaving tips.
Placing the subject in the ‘W’ position with the back supported, knees up and feet on the floor can also reduce the myocardial demand for oxygen. An demo of the ‘W’ position can be found at https://www.sja.org.uk/sja/first-aid-advice/heart/heart-attack.aspx.
TAKE HOME POINTS
- Don’t attempt an event with training properly.
- If you are unwell or feverish on race day then stay home.
- Don’t combine the 4 E’s.
- Keep an eye on your AB girth.
- Keep 300mg Aspirin to hand and learn the ‘W’ position.
- For a comprehensive guide to Cardiac Medication and the relevant exercise considerations please visit http://sportscienceconsultants.com/resources
Richard Brennan is managing director of Sport Science Consultants Ltd. He is a clinically trained Exercise Physiologist with a BSc. in Sport Science and an MSc. in Sport & Exercise Physiology. Click here to read his biography.