I Outwalked a Heart Attack: Brisk Walking at 57
Heart attack at 42, brisk walks every other day at 57. What science says about walking for the heart, how fast and how much.
I had my heart attack at 42. Not at 70, not "someday", but in the middle of a busy working life, when I thought the body was something that simply works. It doesn't. It keeps the score.
I am 57 now. Every other day I walk fast for about two hours. Not jogging, not a gym, just walking at a pace where I can talk but can't sing. Fifteen years on, I like to say I outwalked my heart attack. It is a joke, but only half of one.
This is not medical advice. It is one person's road and what the research says about that road.
Why walking, of all things
After a heart attack, doctors talk about cardiac rehabilitation: supervised exercise, advice and support in the months after you leave the hospital. It is not a luxury. A Cochrane review of 107 trials with almost 27,000 people with coronary heart disease found that exercise-based rehabilitation cut the risk of another heart attack by about a quarter and hospital admissions by about a third, and improved quality of life.
https://pubmed.ncbi.nlm.nih.gov/34741536/
Walking is the simplest form of that exercise. It needs no equipment, no membership and no talent. It is also hard to overdo in a way that hurts you, which matters a lot when you are scared of your own heart.
How much is enough
The World Health Organization advises adults to get 150 to 300 minutes of moderate activity a week, and says that going beyond 300 minutes brings extra benefit. For people over 65 it adds strength and balance exercises three days a week. Its most important line is the simplest one: some physical activity is better than none.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7719906/
My two hours every other day add up to about seven hours a week, more than 400 minutes. I did not start there. Nobody should. The WHO itself says to start small and build up slowly, and that is exactly what a heart patient needs to hear.
Steps, pace and the talk test
How do you know you are walking "briskly" and not just strolling? The US Centers for Disease Control and Prevention suggests a simple check: at moderate intensity you can talk but not sing. For walking, that usually means about 3 miles (5 km) per hour or faster.
https://www.cdc.gov/physicalactivity/basics/measuring/index.html
If you prefer numbers, there are steps. A meta-analysis of 15 studies with nearly 50,000 people found that the more people walked each day, the lower their risk of dying early, up to a point. For adults over 60, the benefit levelled off at about 6,000 to 8,000 steps a day; for younger adults, at 8,000 to 10,000.
https://openaccess.sgul.ac.uk/id/eprint/114197
A two-hour walk is well over 10,000 steps, so on my walking days I am past the point where the curve flattens. The extra steps are not wasted, though. For me they are the time when the head clears.
Does every other day count?
I used to worry that walking every other day, not daily, was "cheating". It seems it is not. A study of almost 90,000 people who wore activity trackers for a week compared those who spread their activity over the week with "weekend warriors" who packed it into one or two days. As long as both groups reached at least 150 minutes a week, both had a clearly lower risk of heart attack, heart failure, atrial fibrillation and stroke than inactive people, and the two patterns did about equally well.
https://www.ukbiobank.ac.uk/publications/accelerometer-derived-weekend-warrior-physical-activity-and-incident-cardiovascular-disease/
What matters is the total and the habit. The schedule is whatever you can keep for years.
What I would tell myself at 42
• Start only with your cardiologist’s approval, and ask about a cardiac rehabilitation program first.
• Begin with short, easy walks and add a few minutes each week. The heart likes patience.
• Use the talk test: talking is fine, singing is not.
• Stop and get help at once if you feel chest pain, pressure, unusual breathlessness, dizziness or a racing, irregular heartbeat.
• Walk in all weathers if you can dress for it. A habit that waits for good weather is not a habit.
• Don’t chase records. Chase years.
Walking did not cure my heart. Medicines, doctors and luck did their part, and I still see my cardiologist. But walking gave me something pills cannot: a feeling that I am doing something for my heart myself, every second day, with my own legs.
Fifteen years ago I thought my life was over. Now my favourite part of it starts when I close the door behind me and the road begins.