Working up a sweat may be even better than angioplasty for some
heart patients, experts say.
Studies have shown heart patients benefit from exercise, and
some have even shown it works better than surgical procedures. At a
meeting of the European Society of Cardiology, several
experts said doctors should focus more on persuading their patients
to exercise rather than simply doing angioplasties.
Angioplasty is the top treatment for people having a heart
attack or hospitalised with worsening symptoms. It involves using a
tiny balloon to flatten a blockage and propping the heart artery
open with a mesh tube called a stent.
Most angioplasties are done on a nonemergency basis, to relieve chest pain caused by clogged arteries cutting off the heart's blood supply.
"It's difficult to convince people to exercise instead of having
an angioplasty, but it works," said Rainer Hambrecht of Klinikum
Links der Weser in Bremen, Germany.
Exercise more effective for some
Hambrecht published a study in 2004 that found heart patients
who rode bikes regularly were free of heart problems one year after
they started their exercise regimen. Among patients who had an
angioplasty instead, only 70% were problem-free after a
Hambrecht is now conducting a similar trial, which he expects to
confirm his initial findings: that for some heart patients,
exercise is more effective than a surgical procedure.
Other experts agreed that would likely be the case. An angioplasty "only opens up one vessel blockage," said Dr Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology. He
was not linked to Hambrecht's research.
"Exercise does a lot more than fixing one little problem."
Exercise could cut heart disuse numbers
Among other benefits, exercise lowers bad cholesterol while
raising good cholesterol, helps the body process sugar better,
improves the lining of the blood vessels and gets rid of waste
material faster. Exercise also lowers blood pressure and prevents
plaque build-up in the arteries.
Previous research has estimated one third of heart disease and
stroke could be prevented if patients did two-and-a-half hours of
brisk walking every week. In the US, that would mean 280 000
fewer heart-related deaths every year.
Joep Perk, a professor of health sciences at Sweden's Kalmar
University and spokesman for the European Society of Cardiology,
said two thirds of heart patients in line for an angioplasty could
probably get better benefits by regularly working up a sweat.
Experts say less than 20% of heart patients get the
recommended amount of exercise - about 30 minutes of moderate
activity five times a week.
Some still opt for ‘quick fix’
Perk said doctors who performed angioplasties on their patients
without asking them to change their lifestyles were ignoring the
fundamental problem. "It would be like getting rid of the most
troubled rust spots on a car without doing anything to stop more
rust from appearing tomorrow."
Still, doctors admitted that persuading patients to exercise
instead of simply going in for an angioplasty, which can take less
than a day, would be a tough sell.
"Most patients want the quick fix," Cannon said. Exercise may
improve patients' hearts better than an angioplasty, but it may
also take months or even longer for patients to feel the benefits.
"It's a lot easier to get your artery fixed than it is to exercise
every day." – (Sapa, August 2009)