New research finds that increased physical activity, not weight loss, gives individuals with coronary heart disease a longer lease on life. Researchers at Norwegian University of Science and Technology (NTNU) have found that heart disease patients can gain weight without jeopardising their health, but sitting in their recliner incurs significant health risks.
Weight loss seems to be associated with increased mortality for the participants in the study who were normal weight at baseline. This observational study was based on data from HUNT (the Nord-Trøndelag Health Study) and the findings are published in the Journal of the American College of Cardiology (JACC).
NTNU researchers studied 3,307 individuals (1,038 women) with coronary heart disease from HUNT. Data from HUNT constitute Norway's largest collection of health information about a population. HUNT patients were examined in 1985, 1996 and 2007, and followed up to the end of 2014. The data from HUNT were compared with data from the Norwegian Cause of Death Registry.
During the 30-year study period, 1,493 of the participants died and 55 percent of the deaths were due to cardiovascular disease.
"This study is important because we've been able to look at change over time, and not many studies have done that, so I am forever grateful to HUNT and the HUNT participants," says Trine Moholdt, a researcher in NTNU's Department of Circulation and Medical Imaging.
Participants in the study were divided into three categories: inactive; slightly physically active, but below recommended activity level; and physically active at or above recommended activity level.
The recommended activity level is at least 150 minutes per week of moderate physical activity or 60 minutes per week of vigorous physical activity.
Results showed that people who are physically active live longer than those who are not. The risk of premature death was higher for the group of patients who were completely inactive than for either of the other groups. The prognosis for those who exercise a little bit, even if it is below the recommended level, is better than not exercising at all.
"Even being somewhat active is better than being inactive, but patients have to maintain the activity level. Physical activity is perishable – if you snooze you lose its benefits," Moholdt explains.
The results indicate that weight gain does not seem to increase risk for already overweight patients, which would mean that it isn't dangerous for a fat heart patient to gain a few pounds. What is dangerous is if the person does not engage in any form of exercise.
The findings in the study showed higher mortality among normal weight heart patients who lost weight. Moholdt points out that the survey is an observational study that does not look at underlying causes. It may be that patients who lost weight were sicker.
Moholdt notes that current guidelines for heart disease patients include having normal weight and being physically active. However, she says more emphasis should be put on the exercise aspect.
"When it comes to physical activity, you have to do what gets you in better shape. That means training with high intensity. Do something that makes you breathe hard, so that it's hard to talk, but not so hard that you can't do it for four to five minutes," says Moholdt. She adds that heart disease patients are often in poor shape, so it often doesn't take much to get into high intensity mode.
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