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Exercise beats angioplasty, MDs told

By: Maria Cheng

Posted: 08/31/2009 1:00 AM | Comments: 0 (including replies)

Two-thirds of angioplasty candidates would be better off with regular exercise than the surgery, one expert says. (RICK MACWILLIAM / CANWEST NEWS SERVICE ARCHIVES)

BARCELONA, Spain -- 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 on Sunday, 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 hospitalized 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.

Hambrecht published a study in 2004 that found that nearly 90 per cent of 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 per cent were problem-free after a year.

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."

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 buildup 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 U.S., 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 angioplasty could probably get better benefits by regularly working up a sweat.

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.

-- The Associated Press

Republished from the Winnipeg Free Press print edition August 31, 2009 A8

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