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Guidelines: Exercise Helps
Heart Failure Patients
NEW YORK (Reuters
Health) - For many people with heart
failure, gone are the days when doctors advised them to rest and
avoid physical activity.
In guidelines announced this week,
the American Heart Association recommends exercise for people
with heart failure, even those who are waiting for a heart transplant.
Some people with heart failure,
including those with unusual heart rhythms, may need to be monitored
during exercise, according to the report. Others may be able to
exercise safely at home after they have undergone a supervised
training program.
"It seems counterintuitive, but
walking, biking, swimming, dancing--all kinds of aerobic exercises--can
help improve the patient's sense of well-being," Dr. Ileana L.
Piņa, who headed the AHA committee that wrote the recommendations,
said in a statement. Piņa is at Case Western Reserve University
in Cleveland, Ohio.
Exercise may provide several benefits
to people with heart failure, including improvements in blood-vessel
function, exercise capacity and quality of life, according to
the report in the March 4th issue of Circulation: Journal of the
American Heart Association. Exercise may also improve the flow
of oxygen to muscles and lower levels of hormones that can contribute
to heart failure symptoms.
The recommendations focus on aerobic
activities, such as riding a stationary bike or walking on a treadmill,
but resistance training, such as lifting light weights, may improve
muscle strength in people with heart failure, according to the
report. The AHA experts caution, however, that the safety of resistance
training in people with heart failure needs to be confirmed in
larger studies.
The AHA recommends an individualized
approach to exercise. People with heart failure should take it
easy at first and slowly increase their exercise as they become
stronger.
Although exercise plans will vary
from person to person, the AHA recommends warming up and cooling
down before and after exercising.
"We know that a rapid sudden surge
of adrenaline is not good for anybody," Piņa told Reuters Health.
"When people stop exercising, the adrenaline goes up initially
and that could leave a patient vulnerable to (abnormal heart rhythms)."
Exercising 20 to 30 minutes three
to five times per week is a good goal, although people who become
exhausted after exercise may need to rest a day between sessions,
according to the report.
In heart failure, the heart becomes
enlarged and loses its ability to pump blood efficiently. Symptoms
include breathlessness, fatigue and swelling of the feet due to
fluid accumulation.
According to the AHA, nearly 5
million people in the US have heart failure.
SOURCE: Circulation 2003;107:1210-1225.
Reference
Source 89
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