Exercise 'reduces deaths' after heart failure

US study demonstrates the benefits of cycling and running in heart failure patients.

Exercise training appears to be safe and could cut mortality rates among patients with heart failure, according to the results of a US study.

The researchers say that the findings appear to put to rest long-held fears that exercising could increase the risk of MI and sudden death among patients who have heart failure.

This latest study involved 2,331 patients with an average age of 59. Patients were randomly assigned to receive regular care or to be enrolled on an aerobic exercise training programme.

Most of the patients - 95 per cent - were taking medications for heart failure such as ACE-inhibitors and beta-blockers.

The exercise programme consisted of 15- to 30-minute sessions of running and cycling. It initially began under supervision but progressed to be self-monitored and home-based.

The benefits of regular exercise were seen after just three months, with 54 per cent of patients in the exercise group reporting an improvement in their quality of life compared with just 28 per cent of patients receiving standard care.

Overall, a total of 387 patients died during the course of the 30-month study.

But exercising did not increase the risk of death, with patients in the exercise group 11 per cent less likely to die than patients who did not exercise regularly.

Patients in the exercise group were also found to have a 15 per cent lower risk of death from cardiovascular disease and hospitalisation due to complications of heart failure.

Lead researcher Dr Christopher O'Conner, from the Duke Heart Centre in North Carolina, said: 'The most important thing we found is that exercise is safe for patients with heart failure.'

Fellow researcher Dr David Whellan, from Thomas Jefferson University in Philadelphia, added: 'It took a study of this size and duration to determine that exercise is not only safe, but also effective in lowering risk of hospitalisation or death for patients with heart failure.'

sanjay.tanday@haymarket.com

- JAMA 2009; 301: 1,439-59

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