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Supervised exercise called better than drugs for common type of heart failure

A new report suggested that exercise like walking, stationary cycling and even dancing about three times per week was more effective than drugs in helping people with symptoms of one of the most common types of heart failure. File Photo by Silvia/Pixabay
A new report suggested that exercise like walking, stationary cycling and even dancing about three times per week was more effective than drugs in helping people with symptoms of one of the most common types of heart failure. File Photo by Silvia/Pixabay

March 21 (UPI) -- Supervised exercise like walking, stationary cycling and even dancing about three times per week was more effective than drugs in helping people with symptoms of one of the most common types of heart failure, according to a new scientific statement.

The statement summarizes the results of a review of studies by experts at the American Heart Association and the American College of Cardiology. It was published Tuesday in the journal Circulation and the Journal of the American College of Cardiology.

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One of the key findings was that exercise therapy had comparable or better results in improving exercise capacity for people with heart failure with preserved ejection fraction compared to those who have heart failure with reduced EF.

Stable heart failure with preserved ejection fraction "occurs when the heart is stiff and does not relax normally to fill with enough blood to pump to the body, yet the heart muscle is still strong enough to pump well," according to a news release from the American Heart Association.

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"In comparison, heart failure with reduced ejection fraction occurs when the left ventricle can't pump with the force needed to push enough blood into circulation," the release noted.

The studies that were examined looked at numerous types of exercise, from walking, stationary cycling, high-intensity interval training, strength training and dancing in facility settings and home-based training.

The statement characterized supervised exercise therapy as being conducted three times per week, and the duration of the programs varied from one month to eight months.

Treatments for heart failure are focused on reducing symptoms, such as shortness of breath and fatigue, along with minimizing or delaying the consequences of the condition.

Those can include decreased quality of life, frequent hospitalizations, loss of functional independence, high health care costs and increased risk of death.

"The prevalence of heart failure with preserved ejection fraction continues to increase due to aging of the population and the growing prevalence of risk factors such as obesity and Type 2 diabetes," said Dr. Vandana Sachdev, chair of the scientific statement writing committee.

"Improved management of this large population of patients who have [heart failure with preserved ejection], many of whom may be undertreated, represents an urgent unmet need."

The statement said heart failure with preserved ejection fraction impacts women more than men.

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"Exercising helps improve the heart's pumping ability, decreases blood vessel stiffness and improves the function and energy capacity of skeletal muscle," Sachdev said.

"Exercise capacity is an independent, clinically meaningful patient outcome, and research has indicated that guided exercise therapy is actually more effective at improving quality of life for people who have [heart failure with preserved ejection fraction] than most medications."

The report's writing committee closely examined research published since 2010 to assess the most current data on the impact of exercise-based therapies for heart failure with preserved ejection fraction.

It found that supervised exercise training may lead to increased peak oxygen uptake 12 to 14%, increased total exercise time by 21% and improved quality-of-life scores on the Minnesota Living with Heart Failure questionnaire 4 to 9 points.

The report also acknowledges the variations in the baseline characteristics of people in the trials reviewed with some excluding patients with some co-existing health conditions.

Also, many groups of people in whom heart failure is prevalent -- such as older adults, women, persons with low socioeconomic status and people from diverse racial and ethnic groups -- were under-represented.

"Future work is needed to improve referral of appropriate patients to supervised exercise programs, and better strategies to improve long-term adherence to exercise training is needed," Sachdev said.

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"Hybrid programs combining supervised and home-based training may also be beneficial. Further, implementation efforts will need to include coverage by Medicare and other insurers."

Earlier this month, a University of Cambridge study suggested that brisk 11-minute daily walks can be enough to lower a person's risk of heart disease, stroke and cancer.

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