Updated May, 2006
A study published two years ago in the British Medical Journal changed a lot of opinions by showing that patients with heart failure can significantly prolong their life expectancy if they engage in an exercise training program. This study provided another nail in the coffin of the "enforced bed rest" school of thought that used to be so prevalent among doctors caring for patients with heart failure.
Now a new study from the April 19 issue of the Journal of the American College of Cardiology adds even more evidence that exercise is fundamentally beneficial in heart failure.
The 2004 report analyzed data from nine separate clinical trials, involving over 800 heart failure patients. Each clinical trial randomized patients with stable heart failure to either participate in an exercise training program, or to receive routine therapy without formal exercise training. Investigators concluded that heart failure patients randomized to exercise achieved a significant increase in survival, as well as a significant decrease in hospital admissions. The benefits were seen without regard to the underlying cause of heart failure - all subgroups of patients seemed to benefit from exercise.
In the latest study, investigators randomized 96 patients with heart failure to receive either standard heart failure therapy plus a 9-month aerobic training program, or standard heart failure therapy alone. They were able to demonstrate that patients randomized to the exercise group had significantly lower levels of a hormone called B natriuretic peptide (BNP) than patients who did not exercise. Elevated BNP levels occur with worsening heart failure, and the lower levels of BNP seen with exercise indicate that fundamental improvements occurred in these patients' cardiovascular systems.
The bottom line: patients with heart failure are rewarded with longer, healthier lives if they engage in exercise. Exercise provides a host of physiological benefits that can directly benefit patients with heart disease. Exercise improves vascular function, thus improving the heart's ability to perform work. It also reduces adrenaline levels, improves muscular function, and reduces the risk of fatal arrhythmias. Patients with heart failure should talk with their doctors about beginning a formal exercise program, and seek their assistance on doing it safely.
