Exercise Helps Some Hearts More Than Surgery
Regular Exercise May Improved Survival Better Than Stenting
March 8, 2004 -- As little as 20 minutes a day on an exercise
bike may help keep people with clogged arteries out of the operating room and
free from chest pain.
A new study shows regular exercise may be better at improving
exercise capacity and preventing heart attacks and other complications than a
common surgical procedure that uses tiny metal mesh tubes called stents to prop
open clogged arteries.
Researchers found men with clogged arteries caused by
atherosclerosis who exercised for 20 minutes a day at an aerobic heart rate
range had a lower risk of heart attack and other complications than those who
had stents surgically implanted. The exercisers also experienced less chest
pain and where able to increase their exercise capacity more than man who had
had stents placed during angioplasty.
"The study was too small to make a general recommendation,
but it suggests that patients with coronary artery disease can get the same
symptom relief by exercising as they could with PCI [percutaneous coronary
intervention] and stenting," says researcher Rainer Hambrecht, MD, of the
University of Leipzig in Leipzig, Germany, in a news release.
Coronary artery disease is the most common form of heart
disease and is usually caused by atherosclerosis, or hardening of the arteries.
Reduced blood flow from a clogged heart artery can lead to heart attacks.
Researchers say stenting will remain the treatment of choice in
the majority of people with coronary artery disease, but these results suggest
that it should be combined with a more aggressive lifestyle intervention
including daily exercise.
Exercise Instead of Stents
In the study, which appears in the March 9 issue of
Circulation: Journal of the American Heart Association, researchers
compared the effects of regular exercise vs. stenting in group of 101 men with
stable coronary artery disease.
All of the men had narrowing of one of the coronary arteries at
the start of the study. About half of them were assigned to receive exercise
training or stenting.
Men in the exercise group worked out on an exercise bike for 10
minutes six times a day for the first two weeks in the hospital. They learned
their target heart rate and were then asked to exercise at home on their bikes
close to their target heart rate for 20 minutes per day and to participate in
one 60-minute group aerobic exercise training session per week.
After one year, both groups experienced an improvement in their
overall symptoms, but that improvement was much greater in the exercise group.
Based on the Canadian Cardiovascular scale, the average chest pain score
dropped from 1.5 at the start of the study to 0.4 a year later in the exercise
group compared with a reduction of 1.7 to 0.7 in the stenting group.
Yet the men in the exercise group were less likely to suffer a
heart attack or other complication during the study with 88% reporting no
adverse events vs. 70% among the men in the stenting group.
In addition, the men in the exercise group improved their
exercise tolerance by 20%. No improvement in exercise tolerance was found among
the men who received stents.
Researchers say exercise would still offer greater benefits
over the newer drug-coated stents because stents can only treat a small section
of diseased arteries at a time, while exercise improves the overall health and
slows disease progression in the entire cardiovascular system.