After surviving a massive heart attack, a celebrated marathoner rediscovers fitness and shares his wisdom
Fifteen minutes—that's how long my heart stopped beating one morning last June. I was coaching a group of elite long-distance runners at Nike's headquarters when suddenly I felt so faint that I bent down on one knee to catch my breath. That's the last thing I remember. I woke up in the hospital two days later. Plaque had narrowed my right coronary artery by 70 to 80 percent. When the EMTs arrived, they shocked my heart eight times to bring me back to life, and after nine days, I returned home with both a stent and defibrillator implanted in my chest.
My cardiologist, Todd Caulfield, credited my heart's resiliency to my level of fitness. Since retiring from competitive running—in the 1980s I won the Boston Marathon and three New York City Marathons, and I competed in the Olympics in Los Angeles—I had remained very active. I ran five days a week, usually about five or six miles an outing, and I swam laps, focusing on slow strokes and steady breathing. Studies show that even moderate exercise, enough to elevate your heart rate slightly for as little as 30 minutes five days a week, can dramatically improve cardiac health. I was actually in such good shape that I passed a physical with flying colors just three months before my heart attack. Still, I'm living proof that running thousands of miles and having eight-pack abs doesn't prevent coronary artery disease. Heart disease runs in my family—it killed my grandfathers, my mom had high blood pressure, and my father has lived through a heart attack—so I've been taking medication to manage my cholesterol and blood pressure for more than a decade. If you're not sure of your own family history, contact the National Society of Genetic Counselors (nsgc.org).
After my heart attack, I became determined not to let the incident get the best of me. Studies have shown that a disconcerting number of heart attack survivors stop exercising, probably because they fear the physical exertion will put them at risk for another episode. Yet research has shown there to be only one cardiac-related death for every 784,000 hours of cardiac-rehabilitation exercise. And, as Dr. Caulfield explained to me, my heart needs exercise now as much as ever. The most important rule is to build a training regimen through regular meetings with your doctor. Early this winter, Dr. Caulfield gave me an exercise stress test, which my heart handled well, and he helped me create a program so that I could resume running. I didn't go far at first, but I gradually increased my mileage until I was clocking about four miles every other day. My pace ranges from 7:30 to 8 minutes per mile now. It's much slower than I've ever run before, but it speaks to how I've reevaluated the priorities in my life. I don't take running as seriously as I once did. When I run, I'm doing it because I enjoy it and it's good for me. I'd much rather be healthy, coach my athletes, and spend time with my 16-year-old daughter than run races. Here's how I've returned to working out after my heart attack, and how you can keep your heart healthy too.
Get an exercise stress test
"An exercise stress test would have shown I was at very high risk for a heart attack. It would have undoubtedly come back as abnormal because I had such tight blockages. During a stress test, you'll run on a treadmill while your doctor monitors your arteries to determine if they're restricting blood flow to your heart. Since my heart attack, doctors have told me that they've seen a lot of fit guys scheduling appointments—a phenomenon that they've dubbed the Salazar syndrome."
Work out with a heart-rate monitor
"Running is an easy way to strengthen your heart because, unlike cycling or rowing, it doesn't require expensive gear. Still, get a heart-rate monitor. It's the best way to improve your cardiovascular health. Use the device to determine your maximum heart rate, and then run at whatever pace keeps you within 70 to 80 percent of that figure—your 'training zone'—four times a week. Your resting heart rate and your heart's ability to return to that rate after exertion will improve within weeks."
Read Cardio Coaches for reviews of the best heart-rate monitors.
Speed things up to build strength
"Once you've established a strong fitness base, add faster-paced anaerobic workouts such as tempo runs and intervals to maximize your cardiovascular efficiency. An easy way to do this is to run a quarter of a mile at your threshold (80 to 90 percent of your max) and then jog for the same distance. Continue this pattern for 15 minutes, rest for five minutes, and then run for another 15 minutes. The only speed work I'm doing for the time being is a short sprint to my front door at the end of a run."
Find a pool
"Swimming works different muscles than running does, it doesn't stress your joints, and you can improve your body's use of oxygen without overworking your heart. Twice a week—on days you're not running—swim for 30 minutes. I'm just getting back into the water now, so I'm starting at an easy, comfortable pace. My heart rate stays below 70 percent of my max so that I expose my heart to a different level of stress than I do with running. Plus, cross training keeps things interesting. A program that bores you into quitting doesn't do any good."
Increase your core strength every day
"I do 50 sit-ups and push-ups every morning, and I spend 15 to 20 minutes stretching. Maintaining flexibility and core strength in the 30 or so muscles that connect your legs to your hips, spine, and rib cage helps the body operate as efficiently as possible during cardio activity, and it will reduce the strain on your heart while you perform day-to-day activities."
Alberto
Salazar, 49, coaches the Oregon Project, a group of athletes dedicated
to rekindling America's tradition of long-distance running.
Fifteen minutes—that's how long my heart stopped beating one morning last June. I was coaching a group of elite long-distance runners at Nike's headquarters when suddenly I felt so faint that I bent down on one knee to catch my breath. That's the last thing I remember. I woke up in the hospital two days later. Plaque had narrowed my right coronary artery by 70 to 80 percent. When the EMTs arrived, they shocked my heart eight times to bring me back to life, and after nine days, I returned home with both a stent and defibrillator implanted in my chest.
