Risk avoidance: Patients with chronic heart failure should not exercise because it is risky. Wrong. A new study shows that for some patients even small amounts of light exercise reduce the risk of death and admission to hospital.
A research group from Imperial College London and the Royal Brompton Hospital, London studied the records of 801 patients with confirmed chronic heart failure. Death and hospital admission rates fell for those taking exercise compared to those who received conventional treatments.
The team, which reported its findings in the British Medical Journal, noted earlier studies had shown that exercise training could reduce debilitating symptoms of chronic heart failure including breathlessness and fatigue. "Despite this, it is not widely utilised, perhaps because data on its effect on survival are limited," the authors suggested.
They decided to provide the missing information, looking in particular at survival and at later hospital admission after a three month-long exercise programme. They chose to examine patients with heart failure due to "left ventricular systolic dysfunction", a condition which makes the heart muscle less elastic. This reduces its ability to pump blood, leaving the patient weak and breathless.
Their work was a "meta-analysis", a reanalysis of research findings done by other groups. It included nine studies, all but one done in centres around Europe. They found that there were 88 deaths in the exercise group compared to 105 in those receiving conventional therapies. When analysed for either death or admission to hospital, the data showed there were 127 deaths or admissions in the exercising group, while there were 173 in the other group after three months.
There was "no evidence that properly supervised medical training programmes for patients with heart failure might be dangerous and indeed there is clear evidence of an overall reduction in mortality", say the authors.
