12/14/2011 - Articles

How Does Exercise Benefit the Failing Heart?

By: John Russo, Jr., PharmD


According to the American Heart Association, "Exercise training in patients with heart failure seems to be safe and beneficial overall in improving exercise capacity." More importantly, at least for me, quality of life improves as well.

But how does this happen; and how much must we sweat to gain these benefits?

The concept that the best heart failure treatment for the majority of patients works by making the heart stronger hasn’t been true for almost 30 years. If it were, digoxin — a drug that increases the force of each heartbeat — would still be the number one treatment today. Not so. Treatment starts with drugs that ease the pumping burden of the heart. Drugs such as angiotensin converting enzyme inhibitors, angiotensin II-receptor blockers, beta-blockers, diuretics, and vasodilators each in their own way allow blood to flow more easily and efficiently through the body.

Similarly, it appears that exercise eases the burden of the failing heart to deliver oxygen-rich blood to the body. The mechanisms responsible for this benefit were reported recently in patients with congestive heart failure who performed simple knee-extensor exercises (straightening the leg) over 8 weeks.

Compared with patients who didn't exercise, knee-extensor exercises significantly increased the amount of oxygen delivered to the leg muscles by about 53%. There were clear improvements in muscle structure, and in oxygen transport and use by the cells. Yet, there was no change in heart function. The researchers concluded that local skeletal muscle training is "a powerful approach to combat exercise intolerance in congestive heart failure."

The bottom line.
Today we know that when supervised by a qualified healthcare professional, exercise training reduces the risk of hospitalizations due to heart failure and improves health-related quality of life.

Avoid getting distracted by the intensity of the exercise. The adage, "No pain, no gain," is archaic and misleading. Rather, identify activities you enjoy. Then, pursue them. A summary of activities with documented beneficial effects in patients with heart disease is presented in the following article.

Benefits of Staying Active as we Grow Older
John Russo, Jr., PharmD

The benefits of exercise in older Americans are not confined to those who Zoomba to exhaustion or speed cycle to dehydration. Today, we know that all levels of activity are good for you. Some physical activity is better than none, and additional benefits occur as physical activity increases. Here are three options to get you started.

Tai chi
   • "Tai chi exercise may be a beneficial adjunctive therapy for some patients with cardiovascular disease and cardiovascular disease risk factors"

   • Yoga is safe and associated with improved physical function and symptom stability

Hydrotherapy (training in warm water)
   • A reduction in heart rate and resistance to pumping results in improved heart function

The Centers for Disease Control and Prevention, in Atlanta, Georgia tell us, "Low-risk lifestyle factors exert a powerful and beneficial effect on mortality." Especially if you have heart disease, talk to your doctor about adding enjoyable physical activities to the other three essentials of healthy behavior: no tobacco; limited amounts of alcohol; and a diet rich in fruits, vegetables, and whole grains.

Created on: 12/14/2011
Reviewed on: 12/14/2011

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