Even for Heart Failure Patients,
Exercise is Prescribed
(Continued From the Front Page)

Exceptions to the “it’s good for you” rule once included people with heart failure. Now, moderate physical activity is no longer discouraged for those with mild to moderate heart failure—but there are necessary precautions. Heart failure is commonly diagnosed only after heart disease, and refers to a condition in which the heart cannot pump enough blood to meet the metabolic needs of the body’s tissues. (Extreme exertion can sometimes cause heart failure in people with normal hearts if there is a mismatch between the needs of the body and the blood volume pumped by the heart. This type of heart failure can sometimes cause confusion about the more common, chronic type referred to here.)

The AHA reports that heart failure patients should use serious caution while weight lifting. The Journal of the American College of Cardiology published data from 14 clinical trials indicating that heart failure patients walking or biking for 30 minutes three times weekly pumped more blood from their hearts than nonexercising heart failure patients. But of the exercisers, those who also strength trained so no increase in blood volume as compared to nonexercisers. This surprising result suggests that by increasing blood pressure and making the heart work harder, weight lifting may negate the effects of walking or biking. However, the AHA stops short or contraindicating strength training, stating that low-level intensity resistance training may help because it preserves muscle mass and tone, both of which rapidly decline in those with heart failure. Lifting a weight 10 to 15 times without becoming exhausted is considered “low-level intensity.”

And finally, exercise is out if you have any of the following conditions: untreated or unstable coronary heart disease; uncontrolled (or “decompensated”) heart failure; severe or untreated arrhythmia; pulmonary hypertension above 55 mm Hg; myocarditis, endocarditis, or pericarditis; blood pressure greater than 180/110 mm Hg; severe or symptomatic aortic stenosis; Marfan syndrome; aortic dissection or significant aortic aneurysm. For more information on these conditions, visit the NIH Medline Plus medical encyclopedia at www.nlm.nih.gov/medlineplus/encyclopedia.html.

Health After 50, 2007, Vol. 19, No. 9, pp. 1-2

Mosby Medical Encyclopedia, rev. ed., 1992, Penguin Books, New York, NY, pp. 71, 363

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