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A LEG UP ON A GOOD HEART
George Crozier
September 21, 1964
From an international conference on cardiology comes word that walking—better still, jogging and running—not only strengthens young hearts but may help prevent attacks in older ones
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September 21, 1964

A Leg Up On A Good Heart

From an international conference on cardiology comes word that walking—better still, jogging and running—not only strengthens young hearts but may help prevent attacks in older ones

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The star quarterbacks of the 1920s may not have had as rosy and green a future as the 1964 quarterbacks, with the pro scouts beckoning, but by and large they did very well for themselves. Mostly they went into business or finance. They gained little weight in the lean 1930s, but then they made good as executives and by the early 1950s they were dying off at an unnatural and alarming rate from heart attacks.

Today's quarterbacks need face no such attrition in their late 40s and their 50s, and neither need other young Americans, if they will heed the advice now offered with refreshing unanimity by experts in such varied fields as cardiology, physical education and rehabilitation. Exercise, it is now generally agreed, is good not only for the young, healthy heart, to keep it healthy as long as possible, but also for the not-so-young heart in a body growing flabby with fat—and even for the man who has already had a heart attack.

Obviously, different kinds of exercise in varying dosages are prescribed for those three main groups of people. But the consensus of the First International Conference on Preventive Cardiology, held at the University of Vermont late last month is that practically all forms of vigorous exercise, including the more active sports, are very good indeed for one's heart.

Almost 2,500 years ago the desirability of exercise seemed so obvious to Plato that he recommended gymnastics for oldsters. But they must have been the few idle rich. Exercise or the lack of it was not a widespread problem until the steam engine, the gasoline engine, electric appliances and countless other devices were invented to keep civilized man from using his muscles. The telegraph and telephone conspired with rapid transit to add a new sense of time urgency to life's stresses.

Soon there developed an epidemic of "arterial degeneration." which has come to a climax in the current wave of deaths from heart attacks. Heart diseases now take a toll of nearly a million Americans every year-250,000 of whom die "prematurely," below age 65.

"In the worry and strain of modern life, arterial degeneration is not only very common but develops often at a relatively early age. For this I believe that the high pressure at which men live and the habit of working the machine to its maximum capacity are responsible," said Sir William Osier, the famed Canadian physician, in 1897. The experts who walked briskly (few of them rode) to the meetings on Vermont's maple-shaded campus in Burlington attach more importance than Osier did to excesses in eating and drinking—and especially smoking. But they believe that man's physical machine should be worked at something much closer to its maximum capacity than it frequently is today, while his mental and emotional equipment should not be pushed so hard.

In research on exercise and the heart most of the emphasis has up to now been on what physiologists think of as the plumbing: the big pump, which is the heart iself, and all those pipes, which are the arteries. The size of the heart has won a lot of attention. So has the condition of the arteries—whether their internal diameter, or bore, is reduced by atheromatous plaques of fatty material ("rust in the pipes"). Millions of dollars are now being spent in nationwide and international studies to find out whether changes in the typically over-rich Western diet will lower the level of fats circulating in the blood; if so, whether these will reduce the numbers of those fatty plaques and, finally, whether the changes will help people to live longer without heart attacks.

The conferees in Burlington started where the plumbing-and-diet fraternity stops. They conceded the importance of a good pump and clean pipes—in fact, they took it for granted. But under the inspiration of Dr. Wilhelm Raab, Vermont's emeritus professor of experimental medicine, who planned and guided the conference, they insisted that plumbing and diet are only half the story. And perhaps not the more important half, at that.

Many things other than physical exercise make the heart beat faster. For a girl it may be the sight of a handsome lifeguard; for an investor, a coldly coded message on the tape, "IBM 435, off 14." Such things affect the heart through highly complex pathways. The light rays from the bronzed torso and the digital quotation are fed into that most versatile of computers, the human brain. There they are processed and set off a chain of reactions through the nervous system and the hormone-secreting glands. Finally, through the body's elaborate and exquisitely sensitive electrochemical servomechanisms, those signals reach the heart in a simple form: "Go faster." And the heart does. Dr. Raab and like-minded investigators, some on the Vermont campus and many in foreign countries, have found that the heart is able to deliver more blood, more efficiently, on demand, when it is "in training" than when it has been allowed to deteriorate by years of under-exercise. Dr. Hans Kraus, famous as co-originator of the Kraus-Weber physical fitness ratings, calls this underexercise "hypokinetic disease." Hypokinetic means slow-motion or, for a majority of today's sedentary workers, no-motion living. As Dr. Kraus and most of the other conference participants saw it, the problem has two heads: 1) the more civilized man becomes, the more he lets his muscles go flabby, to the point of actual atrophy, from simple disuse, and 2) the more civilized he becomes, the more he finds himself obliged to behave rationally and impassively—and usually while remaining immobile—in stress situations that Stone Age man would have resolved simply and instinctively by fight or flight.

The athlete's heart is a trained heart, though it may differ little from that of millions of men living simple lives all around the world who stay in training by doing what comes naturally. It is, said Dr. Raab and others at the conference, the same size as anybody else's heart or only a trifle bigger. The athletic heart at rest beats more slowly than the average man's, at the rate of about 60 per minute. The slow beat is good because it leaves plenty of time for the right ventricle to fill with blood to be forced to the lungs, and for the left ventricle to force out a strong stream of oxygenated blood to the aorta.

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