Heart Health Matters, Even in Heart Failure
For people with heart failure, even simple tasks such as walking to the mailbox can leave them winded and fatigued. A long-term study has confirmed what many heart health experts have suspected, but which until now had remained unproven: supervised, moderate aerobic exercise is safe for many people with heart failure and may improve health and quality of life.
Easing into exercise
These latest results are presented in two papers that detail a study of 2,331 medically stable 59- to 68-year-old heart failure patients, randomized to receive usual care (control) or usual care plus aerobic exercise training (intervention).
The aerobic exercise included three supervised sessions per week over three months for a total of 36 sessions, followed by a home-based program. Initial sessions consisted of 15 to 30 minutes of walking or stationary biking, performed at 60% of heart rate reserve. After six sessions, exercise was increased to 30 to 35 minutes at 70% of heart rate reserve. The final home exercise goal was five times per week for 40 minutes per session, at a heart rate of 60 to 70% of heart rate reserve.
Better life and function
After following the study participants for approximately two and a half years, researchers found:
• The intervention group exercised an average of 95 minutes per week at six months and an average of 74 minutes per week at 12 months.
• After adjusting for severity of heart failure, those in the intervention group were less likely to die of any cause, to die of heart disease-related causes, or to be hospitalized for any reason, including heart failure.
• Those in the intervention group reported significant improvements in health and quality of life, compared with those receiving usual care.
• Improvements in health were seen after three months and continued throughout the duration of the study.
In summary, exercise appeared safe for those with heart failure, benefited the participants quickly, reduced death and hospital admissions, and improved health.
If you have heart failure and you want to begin exercising, keep the following important points in mind:
• Always talk to your doctor before beginning any exercise plan, even simple walking.
• Heart failure is a serious condition. Certain patients with the most severe heart disease were not allowed to participate in the study, because researchers deemed exercise potentially harmful to their health.
• Most study participants did not meet their exercise goals. Even so, those who exercised at least an hour and fifteen minutes per week benefited from the program.
• For the most benefit, try to stick to the exercise goals outlined by your doctor, physical therapist, or exercise physiologist.
• If you are not meeting your prescribed exercise goals, talk to your healthcare provider about ways to address whatever prevents you from exercising.
• Exercise is no substitute for other components of your heart failure care plan. Continue to take all medications as prescribed and to follow your heart failure diet.
April 30, 2009
(JAMA 2009;301:1439-50; JAMA 2009;301:1451-9)
Suzanne Dixon, MPH, MS, RD, an author, speaker, and internationally recognized expert in chronic disease prevention, epidemiology, and nutrition, has taught medical, nursing, public health, and alternative medicine coursework. She has delivered over 150 invited lectures to health professionals and consumers and is the creator of a nutrition website acclaimed by the New York Times and Time magazine. Suzanne received her training in epidemiology and nutrition at the University of Michigan, School of Public Health at Ann Arbor.
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