Thursday, November 13, 2008

Exercise can cut heart failure mortality risk

Working out on a stationary bicycle or walking on a treadmill just 25 to 30 minutes daily can modestly reduce hospitalisation or death risk in heart failure patients, say a new study.

The HF-ACTION trial (A Controlled Trial Investigating Outcomes Exercise Training) led by Dr Christopher O'Connor, director of the Duke Heart Centre showed that exercising improved outcomes for patients who have suffered heart failure.

The study was conducted over 2331 patients, who were randomized, assigned a group that received usual care or to a group that received usual care plus an exercise training program that began under supervision but then transitioned to home-based, self-monitored workouts.

Patients in the exercise arm started out slowly, with a goal of three, 30-minute workout sessions three times per week. After 18 sessions, they transitioned to workouts at home, with a goal of 40 minutes five days per week on a stationary bicycle or treadmill. Patients kept logs of their exercise times and heart rates.

Based on the protocol-specified initial analysis, exercise training produced only a modest, non-significant reduction in the primary endpoint of all-cause hospitalisation or all-cause death.

However a planned, secondary analysis took into account the strongest clinical factors predicting hospitalisation or death and found that exercise was significantly beneficial. They found that those in the exercise group had a significant, 15 per cent lower risk of death from cardiovascular disease and hospitalisation due to complications of heart failure. The researchers hope the findings will finally put to rest long-held fears that exercise may be too risky for some patients.

"The most important thing we found from this study is that exercise is safe for patients with heart failure, and when adjustments were made for specific baseline characteristics, it significantly improved clinical outcomes," said O'Connor.

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