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Cycling and your heart above age 55

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Cycling and your heart above age 55

Old 05-10-21, 05:21 PM
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hereandnow
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Cycling and your heart above age 55

I am 65 and just began road cycling three days a week during the past year and absolutely love it. In general, I've read that intensive exercise is not good for your heart once you're age 55 or so and above. Much more moderate exercise, such as hiking or sports such as pickleball, seems to be the best form of exercise for your heart.

My heart is in decent shape but I still do a stress test on a treadmill with oversight from my cardiologist every few years. I realize that one can choose his own cycling pace, but it feels as if cycling long distances at a decent pace s a mild version of a cardio stress test...in my case three times a week. That doesn't sound so great. We're all going to die of something, but does the idea that cycling long distances at decent speeds might not be a great choice for your heart give anyone else a little pause?

Edit: My cardiologist is not in favor of intensive exercise for anyone above age 55, citing the research of the cardiologist Dr. James O'Keefe, but I know opinions among cardiologists on this topic could vary.

Last edited by hereandnow; 05-10-21 at 05:32 PM. Reason: additional info
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Old 05-10-21, 06:01 PM
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How does your cardiologist define intensive?
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Old 05-10-21, 06:07 PM
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How much exercise is beneficial to your heart, and how much is unsafe?

Ask two people, get two different answers.

Almost nothing about this subject is black and white...Much more research is needed to settle the issue of just how much exercise is safe, and to better understand the links between exercise dosage and heart health...

Although the evidence confirming the health benefits of low- to moderate-dose exercise is strong, the science that explores high-dose exercise is much more speculative and controversial.

—Case et al; The Haywire Heart, How too much exercise can kill you and what can do to protect your heart; Velo Press, 2018
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Old 05-10-21, 06:18 PM
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That Doctor says some weird stuff.

I raised similar questions with four different Cardiologists in the past 2 years. I'll take their advice. Personally, I do a lot of aerobic exercise. I have zero blockages, good blood pressure, and am on no medicines. After reviewing everything, the Russian ElectroPhysiologist looks at me and says, "Total Respect, Total Respect"....."All my patients have problems created by lifestyle, I know how hard it must be to be fit like 20 year old....." When I was checking out, the receptionist asked when he wants to see me again. I said, "never"......she said, "impossible, that has never happened, let me ask him".

I find that recovery from hard days riding take me longer and sometimes need a recovery day more often.

You have to find the answer from a medical professional but I would get another opinion. Pickleball.
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Old 05-10-21, 06:35 PM
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Thanks for the responses.

As far as defining intensive exercise, the sports research cardiologist Dr. James O'Keefe, a former "long distance" athlete himself, recommends running no more than 15 miles a week. Making an estimated conversion to cycling, fwiw, my riding about 150 miles a week at a fairly brisk pace (I love it) is way over Dr. O'Keefe's standard (fwiw, my heart rate is typically 110ish during easy flats; in the 120s quite often; and in the 140s on hills).

We live our lives and take our chances to do what we really enjoy. That said, I am savoring every day of retirement and family and have a variety of interests. I would grudgingly give up cycling if it were certain that I was significantly cutting my life short, all other things equal. Just curious how others above age 55 view the subject who are acquainted with some of the related research or have formed strong opinions on the subject.
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Old 05-10-21, 06:55 PM
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I have four older brothers, none of whom do anything closely resembling exercise. We're talking obesity, mobility challenges, diabetes, diabetes complications, high blood pressure, knee replacements due to excess weight, and broken bones from falling down stairs. I'm 60; they are 64-73.

OTOH, yesterday I rode an easy 35ish miles with 2700 feel of elevation, two weeks ago I did 193 miles with 7k feet of elevation, and in a couple weeks I'll do a 400k (250 miles) with 10kish feet of climbing.

I do understand the good doc recommends something in-between their lifestyles and mine, but I'll take my quality of life thank you very much.

edit:

My brothers all think I live dangerously, and that they live carefully. Yes, I broke my neck on a fast twisty descent 18 months ago and I could have died. But I didn't, and that fast twisty descent was fun as heck, and I'll do it again but try to take a better line.

Further down the road... I'm watching my in-laws ever so slowly decline into the fog of dementia in their 90's, with adult diapers and monthly catheters to test for bladder infections and constant fear and confusion. I've watched nearly all my parents generation pass. I don't know what kind of future the doc wants for me, but we all know what's inevitable. I'm focused on quality, not quantity. I'll take a twisty screaming downhill broken neck death, or a fatal heart attack climbing some pass, over most of the long drawn-out bedridden alternatives I've seen.

Last edited by downtube42; 05-10-21 at 07:23 PM.
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Old 05-10-21, 07:21 PM
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There are quite a few aspects outside cycling that can have an influence.

History in smoking, drinking alcohol, other drug use, stress, regularity of exercise, diet and other consumptions, and medical occurrences and outcomes are among them.

I will do a bit more detailing after I go home from over three days in hospital after suffering a mild heart attack while cycling. I am going to be OK, but I (through a lot of Machka's research skills and knowledge, and doctor advice) have a little bit of my own understanding to pass on.

Also note, I live in Australia where medical costs are not prohibitive, and therefore outcomes can be different.
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Old 05-10-21, 07:43 PM
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Originally Posted by hereandnow View Post
Thanks for the responses.

As far as defining intensive exercise, the sports research cardiologist Dr. James O'Keefe, a former "long distance" athlete himself, recommends running no more than 15 miles a week. Making an estimated conversion to cycling, fwiw, my riding about 150 miles a week at a fairly brisk pace (I love it) is way over Dr. O'Keefe's standard (fwiw, my heart rate is typically 110ish during easy flats; in the 120s quite often; and in the 140s on hills).

We live our lives and take our chances to do what we really enjoy. That said, I am savoring every day of retirement and family and have a variety of interests. I would grudgingly give up cycling if it were certain that I was significantly cutting my life short, all other things equal. Just curious how others above age 55 view the subject who are acquainted with some of the related research or have formed strong opinions on the subject.
Please Read >>>> https://www.georgesheehan.com/bio

MY PCa (Prostate Cancer) while not metastasized at this time (???) was diagnosed as Gleason10, the highest grading PERIOD. Only 5 of every 100 men diagnosed have this high Gleason Score. My fate might be similar to Dr. Sheehan's so in the mean time I am exercising the crap out of my body as best I can. At this moment my bike is ready for a 10:45pm departure (little more than 1 hour) and will be riding at least 50 miles or my age in 2 months from today of 71yo. My suggestion would be to talk to another cardiologist if everything else with you is fine.

Happy exercising!!!
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Old 05-10-21, 08:12 PM
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Originally Posted by Rowan View Post
I will do a bit more detailing after I go home from over three days in hospital after suffering a mild heart attack while cycling. I am going to be OK, but I (through a lot of Machka's research skills and knowledge, and doctor advice) have a little bit of my own understanding to pass on..
Thanks, Rowan. All the best. Take care.

OldTryGuy re: George Sheehan: “The strenuous life tastes better.”
So true. Within reason, just want to know more about the implications of my decisions.
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Old 05-10-21, 09:16 PM
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These threads come up from time to time. Here is a recent one: Do You Worry About Your Heart? - Bike Forums
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Old 05-10-21, 09:40 PM
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Originally Posted by hereandnow View Post

As far as defining intensive exercise, the sports research cardiologist Dr. James O'Keefe, a former "long distance" athlete himself, recommends running no more than 15 miles a week. Making an estimated conversion to cycling, fwiw, my riding about 150 miles a week at a fairly brisk pace (I love it) is way over Dr. O'Keefe's standard (fwiw, my heart rate is typically 110ish during easy flats; in the 120s quite often; and in the 140s on hills).
.
So, 150 miles a week is a description of volume, not intensity. . What’s “fairly brisk?” 100% of lactate threshold? 105%? And is his recommendation that once you turn 55 that you never exceed whatever this limit is? Does this recommendation apply to every 55 year old, even the ones with years of training and competing?

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Old 05-10-21, 11:39 PM
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As a 66 year old I hit 183 bpm on a tough climb and didn’t blow up, but have run my heart hard for decades. Feel comfortable at extended time between 150 and 165 bpm for multi-hour rides. Unless you are not in n shape or have a family history or underlying health conditions I think your cardiologist is playing it way to conservatively. But build up slowly and if you feel anything out of the ordinary, stop and get checked out
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Old 05-11-21, 05:26 AM
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Miles are a horrible way of measuring training load. I have found it extremely rare that any Doctor, unless they are dedicated athletes themselves, to have any understanding of exercise load. 25 miles at threshold is quite different than 25 miles in Zone 1.

Anyway, the Gold Standard to assess risk of an MI is the CT calcium score. It is not expensive, mine was 46 bucks in the USA. Stress tests with ultrasound and 12 lead ECG gets pricey. I would ask that wacky Doctor for the studies demonstrating increased mortality for lifelong and currently practicing endurance athletes? If he says, MI. Ask what tests can be done to assess those risks (CT calcium score). If he says, sudden cardiac death, ask how those risks can be identified and ask for that assessment.

How do I know all that? I have had all the tests. My heart stops many times per night for 6-8 seconds. Talk about scary. So, I have done my homework, had all the tests, saw many Docs. Endurance athletes statistically live longer. Why? They are not fat. YMMV
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Old 05-11-21, 07:16 AM
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I'm 61. Almost all the people in my riding group are over 55. Some are well over. One is 81.

Ride your bike. You'll be fine.
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Old 05-11-21, 07:24 AM
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My mind is going to go before my heart. Probably.

One great thing about experts is that you can always find an equal and opposite expert. There is something to be said for working your way up gradually to more intense riding. OTOH, many experts believe that high intensity training will keep you healthier.
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Old 05-11-21, 07:27 AM
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When 72 after a head crash My Neurosurgeon was amazed at How Strong I was.
I was in Top Riding Shape when I crashed.
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Old 05-11-21, 07:37 AM
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What HR level is intensive to your cardiologist? Aerobic levels or Anaerobic levels?

If it's up in the anaerobic range, then you aren't going to be there long while riding. Most of your riding will be at the aerobic levels. Otherwise, you will only be doing short rides those three days.

Aerobic levels of exercise might not be considered intensive by your cardiologist. But for many of us active older types aerobic efforts can still be a pretty high HR.

If that is indeed the case, then I'd agree with him, riding at only anaerobic levels likely isn't great for anyone at any age. However I routinely go anaerobic on most any ride for brief times. IE, climbing a hill really fast or sprinting ahead of the pack just to show off.
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Old 05-11-21, 07:45 AM
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Some things to watch out for:
  • arrhythmia
  • a racing heart
  • chest pressure or pain
  • labored breathing that seems to come too soon
  • fainting during or just after finishing exercise
  • unable to recover as quickly as you normally do
If you have any of these symptoms, it's time to see your doctor.

Some tips for riding healthy:
  • ride only when you're healthy, never with a fever
  • take recovery days
  • don't overdo your exercise volume, or ramp it up too quickly
Strava premium has a Relative Effort measurement that it displays in a Weekly Effort graph.

The gray band is considered a healthy range. I try to stay in that band.


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Old 05-11-21, 10:36 AM
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Originally Posted by GhostRider62 View Post
Miles are a horrible way of measuring training load. I have found it extremely rare that any Doctor, unless they are dedicated athletes themselves, to have any understanding of exercise load. 25 miles at threshold is quite different than 25 miles in Zone 1.

Anyway, the Gold Standard to assess risk of an MI is the CT calcium score. It is not expensive, mine was 46 bucks in the USA. Stress tests with ultrasound and 12 lead ECG gets pricey. I would ask that wacky Doctor for the studies demonstrating increased mortality for lifelong and currently practicing endurance athletes? If he says, MI. Ask what tests can be done to assess those risks (CT calcium score). If he says, sudden cardiac death, ask how those risks can be identified and ask for that assessment.

How do I know all that? I have had all the tests. My heart stops many times per night for 6-8 seconds. Talk about scary. So, I have done my homework, had all the tests, saw many Docs. Endurance athletes statistically live longer. Why? They are not fat. YMMV
Even calcium score is not a good guide. Endurance athletes frequently have high calcium scores, yet don't have heart attacks. Their calcium deposits are more solid and less likely to come loose. I did at stress test at ~70 and had a score equivalent to a fit 43 y.o. My cardiologist said, "Do whatever you want." I'm 75 now. My calcium score is very high ~700.
See: https://www.ahajournals.org/doi/full...aha.117.028750
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Old 05-11-21, 11:41 AM
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I have had 3 riding buddies so far who got Afib. Here's a good recipe: Be in your 60s, lifetime of hard training, wall full of long distance medals, your 3Xweek normal workout is a 60 mile ride including 3 repeats of a 1000' steep climb and then finishing with an all out climb of 1/2 mile of 18%. The other 2 weren't quite as extreme, but almost. One friend recently died in bed of a heart attack at ~60, only been riding for 3 years, but very strong, very athletic. The day he died he spent the day backcountry skiing, came home, made dinner, walked the dog, climbed into bed and passed.

I have the blood pressure of a healthy 25 y.o., resting HR of 46, and will do 11 hours of aerobic exercise this week, ~10% of that time in zones 4 and 5, TSS of ~600. I don't worry about it, Worry is bad for your heart.
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Old 05-11-21, 12:10 PM
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Originally Posted by rsbob View Post
As a 66 year old I hit 183 bpm on a tough climb and didn’t blow up, but have run my heart hard for decades. Feel comfortable at extended time between 150 and 165 bpm for multi-hour rides. Unless you are not in n shape or have a family history or underlying health conditions I think your cardiologist is playing it way to conservatively. But build up slowly and if you feel anything out of the ordinary, stop and get checked out
Same age and heart rate numbers for myself.
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Old 05-11-21, 12:31 PM
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Everyone's going to have a different history when it comes to conditions, metabolism, impact with situations like reduced hydration and increased effort. Everyone's going to have a different general level of fitness and how one's muscles respond to increased loads. It's all well and good to have general guidelines, but they'll remain general and might well not apply fully to a given person in a given situation or point in their lives.

I was once extremely fit, strength-wise and cardiovascularly. There was almost nothing I couldn't do physically, within my area of sport. (Though of course I had a max cap on speed, range of motion, etc, based on my body's limb lengths and whatnot.) Could keep doing it at levels of intensity and for periods significantly longer than most people I trained with and raced against. But, that was peak fitness and peak intensity ... and that level of performance only occurred across a handful of years. There's good reason why in many disciplines a 28yr old person can be considered an "elder" in a sport. Bodies change, as does flexibility, ability to hit an intensity, as does our history of physical activity and whether we've maintained the body's similar abilities in key areas.

Here I am in legitimate older fart territory, and I'm nowhere near as fit. Age-old injuries and greatly reduced levels of intensity have conspired with time to change what I'm capable of producing at a given moment. And that'll be different than what many write-ups and books say on the matter, as I'm me and not the "general" case a book might speak of.

So I rely on my ongoing fitness and activities, my doctor's knowledge and recommendations, and my common sense based on my history and my record of activity. Haven't had a "bump" yet, though I'm certainly more cautious and aware of the risk areas now as compared to what existed for me 40yrs ago.

Gotta love getting old. Ain't for sissies, or so everyone tells me.
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Old 05-11-21, 12:40 PM
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I refuse to worry about things like this. I'm 76 and believe I have a good sense of what's right for my body. A massive (and fatal) heart attack after a hard day of riding is not a bad way to go.
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Old 05-11-21, 12:47 PM
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Originally Posted by Inusuit View Post
I refuse to worry about things like this. I'm 76 and believe I have a good sense of what's right for my body. A massive (and fatal) heart attack after a hard day of riding is not a bad way to go.
What was it that Jack Nicholson's character said in the film The Bucket List, as he's feeling crappy following a chemotherapy round?
"Somewhere, some lucky guy is having a heart attack."

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Old 05-11-21, 03:29 PM
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Having seen this thread many times before.....I skipped all the replies.

Reference: 70yo, 35 year road cyclist, No medications,
100mi/wk, 7-8mo/year has been the goal lately, usually achieved.
150mi/wk - when younger - often missed when kids were young.

Question: How to train?
Answer: It depends.

What is your medical history + current condition?
What are you training for?

If training for a competitive goal or timed century or Masters Olympics - then you have need for a structured program that will include intensity. How much? Depends?

If training to substantially lose weight, lower blood pressure, overcome Type2 diabetes, etc - a structured program should greatly help. Intensity? Depends?

If training to maintain one's health and feel as good as possible each morning/noon/night - well maybe, Listen to the Body, Move, Smile.
Cardio+Strength =

Lots of branches on that tree of Intensity.

Personally, gardening a 1acre property bordered by forest 180° - by hand - is a combo of stretching, yoga, tai-chi, hand strengthening, and other stuff. Oh yeah, hiking in that forest mostly fills in a lot of the non-cycling months, now that I ski less.





edit: Clear your handlebars and your mind will follow.

Last edited by Wildwood; 05-12-21 at 02:19 PM.
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