April 16, 2009
Exercise benefits heart patients
Studies show that quality of life and survival rates improved with workouts
Patients with heart failure have traditionally been told to rest, but that recommendation is changing in the light of evidence that suggests physical activity is beneficial and may even increase survival rates in some patients.
Two studies, to be published in The Journal Of The American Medical Association, report data from a multi-centre, randomised, controlled clinical trial sponsored by the National Heart, Lung and Blood Institute.
One analysis found that exercise improved overall well-being, while the other found that it slightly reduced the risk of hospital admissions and death.
'I think we can say with a high degree of certainty that (exercise) is safe,' said Dr Christopher O'Connor, the principal investigator of the trial and director of the Duke Heart Center at the Duke University School of Medicine in Durham, North Carolina.
'The message for the average heart failure patient is: We believe there are benefits from exercise. Quality of life is important and physical fitness is important.'
However, he added: 'If you don't exercise because you don't want to or you can't because of orthopaedic issues, you're not going to harm yourself dramatically.'
Although medications and other treatments exist, people who have heart failure, in which the heart loses its ability to pump enough blood to supply the body's needs, often suffer from poor quality of life. Simple activities like climbing stairs leave them tired and short of breath and they are frequently hospitalised and at high risk of premature death.
The trial followed 2,331 stable heart failure patients from the United States, Canada and France with a median age of 59. Fewer than one-third were women.
The patients were randomly assigned to their usual medical care or to standard treatment combined with an aerobic exercise programme and then followed for 21/2 years on average.
Death and hospitalisation rates were only slightly lower in the exercise group. About 65 per cent, or 759 patients, in the exercise training group died or were hospitalised, compared with 68 per cent, or 796 patients, in the usual care group. After accounting for several variables, the scientists determined that patients who exercised cut their risk of death and hospitalisation by 11 per cent.
Dr Katherine Flynn, an assistant professor of psychiatry and behavioural sciences at the Duke School of Medicine, said over half of the patients who exercised had palpable improvements in quality of life measures, compared with only 29 per cent in the group that received usual care.
Risk of death and hospitalisation went down by 11% for patients who exercised