Pumped-Up Workouts May Benefit Heart Patients

Study weighs moderate vs. high-intensity exercise

For heart patients, the benefits of forgoing couch surfing in favor of a formal cardiovascular rehabilitation program are impressive:

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  • Cardiovascular death is reduced by 47% as compared with nonparticipants in cardiac rehab programs; and
  • The safety of supervised programs is extremely high.

Now, the results of a recent study show promise that more might be even better when it comes to exercise intensity during cardiac rehab in patients with coronary artery disease (CAD). Researchers found that in patients with CAD who were recovering from a cardiovascular event such as a heart attack or from heart surgery, the risk of a sudden cardiac event was low after both:

  • High-intensity exercise; and
  • Moderate-intensity exercise.

The study included nearly 5,000 patients who were closely monitored in a cardiovascular rehabilitation setting. While it is well-known that higher levels of physical activity and greater aerobic exercise capacity reduce the overall risk of cardiovascular events and death, the study results are a step toward answering concerns about whether more vigorous exercise could precipitate a sudden heart attack or cardiac death in at-risk patients.

“The findings are promising, but more data are needed before high-intensity interval training becomes the standard format of training for all cardiac patients,” says Gordon Blackburn, PhD, Program Director, Cardiac Rehabilitation, Cleveland Clinic’s Department of Cardiovascular Medicine, Miller Family Heart & Vascular Institute.

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Dr. Blackburn explains that:

  • High-intensity interval training (HIIT) means that you exercise at 80 to 95 percent of your peak capacity for brief periods, followed by “active rest” periods at 50 to 70 percent intensity.
  • The gold standard for cardiac rehabilitation programs is moderate intensity exercise, which means that you train at a constant, moderate pace at 60 to 70 percent intensity.

“The findings from this study suggest that HIIT not only provides greater improvement in functional capacity, and as such perhaps a greater reduction in cardiovascular death, but the risk of exercising at higher intensity is similar to that of exercising at the traditional 60 to 70 percent intensity,” Dr. Blackburn says. He cautions however, that the number of cardiac events in the study was so low that statistically, it is not possible to say with certainty that there is no added risk with HIIT.  

While the results of the study may prove to be good news for our high-intensity athletes who come to Cleveland Clinic for heart surgery (see stories below), additional studies are needed. Until more is known about the risks and rewards of HIIT in patients with CAD, Dr. Blackburn says that moderate-intensity training remains the cardiac rehabilitation therapy of choice.

As with any exercise or rehabilitation program,your individual mileage may vary—so it’s important to discuss your heart condition and treatment goals with your doctor, surgeon and cardiac rehabilitation professionals.

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One thing is certain: Participating in a supervised cardiovascular rehabilitation program is one of the most crucial steps that a heart patient can take to decrease future risk. As screenwriter/director Woody Allen once said, “Eighty percent of success is showing up.”

Read about Cleveland Clinic patients who are post-heart surgery star athletes:

More Information

Coronary Artery Disease – Overview

Thoughts on Marathon Mortality

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