By Peter M. Abel, M.D.
Medical Director
Prevention Center for Cardiovascular Disease
Cardiovascular Institute of the South

"See your doctor before beginning any new exercise program." Words to that effect accompany just about every piece of exercise equipment or solicitation for health club membership you encounter. But is seeing your doctor really necessary?

If you're over 40, if you have a family history of early-onset heart disease, or if you have any personal history of cardiovascular problems, the answer is a resounding "yes!" Even much younger adults, particularly those who smoke, are considerably overweight, who suffer from diabetes, high blood pressure or high blood cholesterol, or who have not exercised much for a long time would be well advised to undergo such a pre-exercise physical.

All these conditions of age, behavior and health increase the risk of coronary artery disease -- blockages of the arteries providing oxygen-carrying blood to the heart muscle itself. If you suddenly impose an increased load on the heart by exercise, you could unmask a hidden heart problem.

The basic pre-exercise physical should include a review of your medical history, a blood test and an EKG -- all of which can be performed in your doctor's office at a reasonable cost. If you are over 40, I strongly urge you to add a treadmill stress test to the examination. It lets your doctor determine how your heart performs under increased demand.

But even a good checkup shouldn't be taken as absolute assurance that you are not at some coronary risk. Begin your exercise program at a low level and increase the amount of exertion gradually. The athlete's dictum of "no pain, no gain" is utter nonsense -- and doubly so for the unsupervised amateur. Avoid overexertion in our area's high heat and humidity. It's an invitation to heat exhaustion -- or worse.

And be on the alert for signs of possible heart problems -- chest pains, easy fatiguability, shortness of breath out of proportion to the amount of exertion, dizziness, lightheadedness or heart palpitations. &Copy 1995 Cardiovascular Institute of the South

For further information, call Jane Arnette, Cardiovascular Institute of the South/Houma, 1-800-425-2565, or Jim Keyser at 1-800-848-2715. E-mail questions or comments to: jakeyser@cardio.com.

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