Exercise after heart attack may improve survival

By American Heart Association News

Older couple riding bikes on a trail
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Exercising after a heart attack, even a long walk around the neighborhood, can be frightening for survivors. But those fears may be eased by new research that found regular physical activity could help keep them alive.

Many heart attack survivors initially worry that exercise or any type of prolonged activity that increases their heart rate could strain their recovering heart. But a new Swedish study published Tuesday in the Journal of the American Heart Association found even a low level of physical activity within the first year of a heart attack was enough to reduce the odds of dying in the immediate years that followed.

Swedish researchers used a national registry to examine data on 22,227 heart attack patients from 2004-2013. Patients were asked about their activity level during a follow-up visit six to 10 weeks after their heart attack, and then again about a year following the event.

Researchers then categorized the patients into four groups based on their self-reported activity, sessions that were 30 minutes or longer within the previous week.

Those who reported they had "increased activity" between the two follow-up visits had a 59 percent lower risk of dying over the next four years compared to people classified as "constantly inactive" during both follow-up visits. The "constantly active" group had a 71 percent lower risk of death than the inactive group.

But even heart attack survivors who dialed down their workouts appeared to improve their odds of survival: The group of patients who reported "reduced activity" between their first and second follow-up had a 44 percent lower risk of death than survivors who were constantly inactive.

"We've been calling it a carry-over effect. Maybe these people were active for many years and then had to stop for some reason, but they still have that protective effect," said Orjan Ekblom, the study's lead author and an associate professor at the Swedish School of Sport and Health Sciences in Stockholm.

The study supports exercise as "one of the most important medicines people can take before cardiac events but, in particular, after them as well," said Dr. Randal Thomas, medical director of the cardiac rehabilitation program at the Mayo Clinic in Rochester, Minnesota.

The study sends a clear message that "any amount of activity" can benefit survivors, although regular activity should be the goal, said Thomas, who was not connected with the new research.

"Sometimes people think, 'Oh, I'll exercise for a few weeks and once I'm all better, I'll go back to my old ways of living.' But this really is a good study to show that maintaining those healthy changes can make a big difference," he said. "We tell patients it's never too late to start to get those benefits."

Ekblom agreed, saying he hopes the findings will help provide motivation to those tentative about starting an exercise routine after their heart attack.

"It can be scary for many reasons," he said. "They have this heart for many years that they trusted and all of a sudden it failed them. They lost faith in it, or they lost their sense of security."

While most patients undergo initial attempts at exercise in a supervised setting through cardiac rehabilitation, it's a bit different to continue those efforts outside the safety and watchful eye of rehab therapists or hospital workers, Ekblom said.

"I hope this will encourage people to at least try to stay active," he said. "As soon as they see, 'Well, the first attempt went well, the second attempt went well,' maybe that's all it takes for them to feel more secure again."

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