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Arthritis and Heart disease

Arthritis and Heart disease Word Cloud


Why is the presence of arthritis in people with heart disease important?

Arthritis may be a barrier to increased physical activity among adults with heart disease.1

Being physically active is an important component of heart disease management; however, people with heart disease are less likely to comply with physical activity recommendations than those without heart disease. Increasing physical activity (for example, through aerobic exercise or strength training) can benefit people with heart disease.

What are the benefits of increased physical activity for people with heart disease and arthritis?

People with heart disease who are inactive and become more active benefit from the following:

  • Improved physical function.
  • Lowering blood pressure.
  • Lowering low-density lipoprotein cholesterol levels.2, 3

There are many general health benefits for adults through physical activity. The recently released 2008 Physical Activity Guidelines for Americans by the U.S. Department of Health and Human Services describes many of these benefits.

Compared to less active people, more active men and women have the following:

  • Lower rates of all-cause mortality.
  • Lower occurrence of high blood pressure, stroke, type 2 diabetes, and metabolic syndrome.
  • A higher level of cardio-respiratory and muscular fitness.
  • Healthier body mass and composition.
  • A biomarker profile that is more favorable for preventing type 2 diabetes and for enhancing bone health.

In addition, being physically active is associated with the following:

  • Higher levels of functional health.
  • A lower risk of falling.
  • Better cognitive function.

Despite these benefits, many people with heart disease are physically inactive. Being physically inactive is an even bigger problem for people with heart disease who also have arthritis.
 

People with heart disease, like most adults, face common barriers to being more physically active

  • Lack of time.
  • Competing responsibilities.
  • Lack of motivation.
  • Difficulty finding an enjoyable activity.1

Adults with heart disease who also have arthritis face additional, disease-specific barriers

  • Concerns about aggravating arthritis pain.1
  • Fear about causing further joint damage.
  • Uncertainty about which types and amounts of activity are safe for their joints.

Despite these benefits, 1 of 5 people with heart disease (21%) are physically inactive. Being physically inactive is an even bigger problem for people with heart disease who also have arthritis (Figure 1). Physical inactivity is most common in adults who have both arthritis and heart disease. Almost one-third of adults, or one in three, with both conditions are physically inactive. Physical inactivity puts people at greater risk for complications from chronic conditions.

Figure 1. Physical inactivity is most common among adults who have both heart disease and arthritis

Bar chart showing physical inactivity is most common among adults who have both heart disease and arthritis. A more detailed is found in the paragraph above this figure.

Physical inactivity among adults age ≥18 years, by arthritis and heart disease status—Behavioral Risk Factor Surveillance System, United States, 2005 and 2007.

Source:
Bolen J, Murphy L, Greenlund K, , Helmick CG, Hootman J, Brady TJ, Langmaid G, Keenan N. Arthritis as a potential barrier to physical activity among adults with heart disease — United States, 2005 and 2007. MMWR 2009;58(7):165-169.
html; pdf [1.25MB] page 165.

What can people with heart disease and arthritis do to overcome the challenges of both conditions?

Existing resources, such as self management education programs and physical activity programs, are designed to teach people the skills they need to take charge of their conditions and engage in effective, joint-friendly physical activity.

Self-management education programs

Self-management education programs teach people techniques to manage their chronic diseases, such as heart disease and arthritis on a day-to-day basis. Specially tailored self-management education interventions, such as the Chronic Disease Self Management Program, and the arthritis-specific Arthritis Foundation Self-Help Program, help adults learn to manage arthritis pain and discuss how to safely increase physical activity.

  • Chronic Disease Self-Management Program (CDSMP) is an effective self-management education program for people with chronic health problems. The program specifically addresses arthritis, diabetes, lung and heart disease, but the skills taught are useful for managing a variety of chronic disease. This program was developed at Stanford University. CDSMP workshops are held in community settings and meet 2 1/2 hours per week for 6 weeks. Workshops are facilitated by two trained leaders, one or both of whom are nonhealth professionals with a chronic disease themselves. This program covers topics such as,

    • Techniques to deal with problems associated with chronic disease.
    • Appropriate exercise.
    • Appropriate use of medications.
    • Communicating effectively with family, friends, and health professionals.
    • Nutrition.
    • How to evaluate new treatments.

    Participants who took CDSMP demonstrated significant improvements in the following:
     

    • Exercise.
    • Communication with physicians.
    • Self-reported general health.
    • Health distress.
    • Fatigue.
    • Disability.
    • Social/role activities limitations.

    Locate your state arthritis program. More information about CDSMP is available.

     

  • Arthritis Foundation Self-Help Program (AFSHP) is an effective self-management education intervention for people with arthritis. Developed by Dr. Kate Lorig of Stanford University, the course helps people learn and practice the different techniques needed to build an individualized self-management program and gain the confidence to carry it out. The 6-week course consists of weekly 2-hour sessions guided by 2 trained instructors who follow a detailed protocol. There is a robust science base that demonstrates the positive impacts of participation in the Arthritis Foundation Self-Help Program—participants report a 20% decrease in pain, and a 40% decrease in physician visits, even 4 years after course participation. To find out about availability in your area you can check with the Arthritis Foundation or view this map to locate your state arthritis program.

Physical activity programs

Several exercise programs, including EnhanceFitness®, the Arthritis Foundation Exercise Program, and the Arthritis Foundation Aquatics Program, are available in many communities and are appropriate for adults with arthritis and heart disease.

In addition, people with heart disease and arthritis can engage in joint-friendly physical activity on their own or with friends. Some of the joint-friendly physical activities that are appropriate for adults with heart disease and arthritis are as follows:

  • Walking.
  • Swimming
  • Riding a bike.

For more information on joint-friendly exercise programs, visit CDC’s Arthritis Web site at http://www.cdc.gov/arthritis/intervention.

For more information on heart disease, visit CDC’s heart disease web site at http://www.cdc.gov/heartdisease/.

References:

1. Bolen J, Murphy L, Greenlund K, Helmick CG, Hootman J, Brady TJ, etal. Arthritis as a potential barrier to physical activity among adults with heart disease — United States, 2005 and 2007. MMWR 2009;58(7):165–169. html; pdf [1.25MB] page 165.

2. U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. Hyattsville, MD: U.S. Department of Health and Human Services; 2008. Available at http://www.health.gov/paguidelines.

3. Smith SC Jr, Allen J, Blair SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update. Circulation 2006;113:23:63–72. Free access html pdf [611KB]

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