By Dr. P K Ranga Rao


While most people do not get enough, many people on the other end of the spectrum often cross over the threshold of what is a healthy amount of exercise. Some people exercise too much — either by exercising too intensely or too frequently.


In a long-term study, researchers in the US found that the participants with relatively high levels of physical activity (more than 7.5 hours per week) were 27 percent more likely to develop coronary artery calcification (CAC) — characterised by plaque buildup — by the middle age compared to those who exercised for under 2.5 hours per week.


Cardio exercises – such as cycling, running, climbing stairs, and swimming – are great for stress relief and burning calories. But more importantly, cardio offers the best workouts for a healthy heart. Cardio is a form of exercise that stimulates the heart to beat at a higher rate than usual, enabling the pumping of oxygenated blood to muscles and other tissues and organs in the body.


As cases of heart attack and heart ailments rise worldwide, it is becoming a significant area of concern for healthcare providers. It is seen that cardiovascular diseases are the leading cause of death globally, taking an estimated 17.9 million lives each year.


People mainly concentrate on fitness and workouts, yet they land up with heart disease or malfunction, especially after COVID-19. The basic problem is with the clot, whether in the brain or the heart. COVID-19 causes two major problems: One is the infection, and the other one is the clotting mechanism. Brain strokes happen due to clots in the brain, and heart strokes because of clots in the heart.


Also, one of the major causes of sudden death is Pulmonary Thromboembolism, and pulmonary embolism occurs when a piece of the clot breaks off and reaches the lungs, posing a severe health risk. DVT, PE, or both are referred to as venous thromboembolism (VTE). Long-term issues, such as postthrombotic syndrome after a DVT or chronic thromboembolic pulmonary hypertension after a PE, are common with VTE.


Also, blood vessels supplying blood to the lungs get blocked, known as Pulmonary Thromboembolism. That is one of the major causes of sudden deaths. During COVID-19, many patients were prescribed anticoagulants by doctors. When one family member is often prescribed a certain medication or routine for COVID-19, the entire family begins following it. One must understand that medications prescribed have to be as per the current health condition of each patient.


Improper treatments and medications taken on a wide scale during the pandemic have added to the public health problem in India. If the exercise is on top, it leads to more complications.


When compared to people who do not exercise, exercise, even strenuous exercise, is associated with enormous heart health benefits in the vast majority of people. On the other hand, exercise can cause arrhythmia in a very small minority of people with underlying issues. It is always a good idea to run your exercise and nutrition regime past a certified trainer. Suppose there are underlying factors such as tobacco and alcohol use, unhealthy eating, hypertension (high blood pressure), high cholesterol, sleep deprivation, diabetes, obesity, and a prolonged inactive lifestyle. In that case, one must start exercising in consultation with their doctor. It is an oft-seen tendency that people do not give themselves time to recover after an infection or mild condition. Repair and recovery are essential parts of any exercise routine.


Pranayama and yoga are good alternatives for exercise for those who cannot or have been told not to engage in hardcore exercises. Twenty minutes of pranayama (breathing exercise) on an empty stomach can give equal and more profound benefits.


However, there are different kinds of pranayama which increase abdominal pressure, like Bhastrika (or any technique involving forceful expiration) cannot be done in cardiac patients. People who do too much pranayama, like Bhastrika, may get more benefits, but in the long term, they may develop a hernia, and women may land up in uterine prolapse.


Thiamine deficiency is common in people who consume a lot of alcohol. Thiamine deficiency affects up to 80% of people who are addicted to alcohol.


Heavy alcohol consumption causes stomach lining and digestive tract inflammation, which reduces the body's ability to absorb vitamins. Poor dietary choices and a lack of nutrition deplete the body of essential vitamins as well. If the body continues to have problems with thiamine absorption, it can lead to serious heart problems like cardiomyopathy, which can be lethal if not treated. To treat cardiomyopathy, thiamine is injected into the body, which magically brings the body back to a stable state.


In fact, a high homocysteine level is a risk factor for heart disease. It's linked to low levels of B6, B12, and folate and renal disease. As a result, lowering serum homocysteine levels decreases the risk of IHD (Coronary Heart disease) and can be accomplished by supplementing B Complex vitamins on a regular basis. As these B-complex vitamins are water soluble and cannot be stored in the body for a longer period, and thus needs to be supplemented regularly to reduce the risk of heart attack or death from heart disease.


The author is Dr. P K Ranga Rao, MBBS, PGDCC, MBA (HA)., and Senior Resident, Department of Cardiology at GITAM Institute of Medical Sciences and Research