Exercising after a heart attack could save your life

A Swedish study of more than 22,000 patients indicates that becoming more physically active after a heart attack halved the risk of death within four years. The findings were presented at EuroPrevent 2018, a European Society of Cardiology congress.

Physical activity and exercise have been shown to reduce the risk of a heart attack and to help people live longer. "However," said lead Dr. Örjan Ekblom, "we did not know the impact of exercise on people after a heart attack."  

In this study, Dr. Ekblom, an associate professor, Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden, and colleagues examined the association between physical activity and survival after a heart attack. The study included 22,227 patients in Sweden who had a myocardial infarction between 2005 and 2013. Data was obtained from the RIKS-HIA registry, SEPHIA registry, and Swedish Census registry.

Levels of physical activity were reported 6-10 weeks and 12 months after the heart attack. The difference between answers was considered a change in physical activity over the year following the heart attack. On both occasions, patients were asked how many times they had exercised for 30 minutes or longer during the previous seven days. Patients were categorised as constantly inactive, reduced activity, increased activity, or constantly active.

A total of 1,087 patients died during an average follow-up of 4.2 years. The researchers analysed the association between the four categories of physical activity and death, after adjusting for age, sex, smoking, and clinical factors. Compared to patients who were constantly inactive, the risk of death was 37%, 51%, and 59% lower in patients in the categories of reduced activity, increased activity, or constantly active, respectively. Even patients who reported being physically active 6 to 10 weeks after the heart attack but became inactive afterwards seem to have a carry-over benefit, according to Dr. Ekblom.

The findings provide additional evidence for healthcare professionals and policy makers to systematically promote physical activity in heart attack patients. As the doctor pointed out, "Exercising twice or more a week should be automatically advocated for heart attack patients in the same way that they receive advice to stop smoking, improve diet, and reduce stress."

However, the study did not investigate what type of exercise patients undertook. "More research is needed to find out if there is any type of activity that is especially beneficial after a heart attack," Dr. Ekblom said. "Should patients do resistance exercise, aerobic training, or a combination, for example? Is walking sufficient or do patients need more vigorous exercise which makes them short of breath? Answering these questions will help us to give more specific advice."

Source: European Society of Cardiology
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