Women with heart disease benefit more from exercise than men

Washington: Women heart patients tend to benefit more from exercising than men, according to the largest study of its kind.

The study investigated the effects of exercise training in patients with heart failure and found that exercise training reduced the risk for subsequent all-cause mortality or all-cause hospitalidation in women by 26 per cent, compared with 10 per cent in men.

While a causal relationship has previously been observed in clinical practice between improved health outcomes and exercise, this trial is the first to link the effects of exercise training to health outcomes in women with cardiovascular disease.

"This trial was uniquely positioned to review results of exercise training in women compared with men since we included a pre-specified analysis of women, we used the largest testing database ever acquired of women and the population was optimised with medical therapy," said Ileana Pina from Montefiore Medical Center in the US.

"Heart disease has a major impact on women. Our goal is for these findings to greatly impact the management of this challenging syndrome," Pina said.

The randomised, multicenter, international HF-ACTION (The Heart Failure - A Controlled Trial Investigating Outcomes of Exercise Training) trial included the largest cohort of women with heart failure to undergo exercise training, and examined potential gender differences that could affect physical exercise prescription.

"Findings suggest physicians should consider exercise as a component of treatment for female patients with heart failure, as they do for male patients," Pina said.

The clinical trial randomised 2,331 patients with heart failure and a left ventricular ejection fraction of less than or equal to 35 per cent to either a formal exercise programme plus optimal medical therapy, or to optimal medical therapy alone.

Prior to randomisation, patients underwent symptom-limited cardiopulmonary exercise tests to assess exercise capacity, as measured by peak oxygen uptake (VO2).

Patients randomised to the exercise treatment arm participated in supervised walking, or stationary cycling for 30 minutes three days a week for six weeks.

After completing 18 sessions, patients added 40 minutes of home-based exercise two days per week. After completing 36 supervised sessions, patients were fully transitioned to a five day per week, 40 minutes a day home-based exercise programme.

Women randomised to exercise training saw a 26 per cent reduction in risk of all-cause mortality or hospitalization compared with a 10 per cent reduction in risk of these outcomes for men randomised to exercise.

The study was published in the Journal of the American College of Cardiology: Heart Failure.