- The Washington Times - Monday, August 31, 2009

BARCELONA | Working up a sweat may be even better than angioplasty for some heart patients, researchers say.

Studies have shown that heart patients benefit from exercise, and some have shown it works better than surgical procedures. At a meeting of the European Society of Cardiology on Sunday, several researchers said doctors should focus more on persuading their patients to exercise rather than simply performing angioplasties.

Angioplasty is the top treatment for people who are having a heart attack or are hospitalized with worsening symptoms. It involves using a tiny balloon to flatten a blockage and propping open the heart artery with a mesh tube called a stent. Most angioplasties are performed 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 Dr. Rainer Hambrecht of Klinikum Links der Weser in Bremen, Germany.

Dr. Hambrecht published a study in 2004 that found that nearly 90 percent of heart patients who rode bicycles regularly were free of heart problems one year after they started their exercise regimens. Among patients who underwent angioplasties instead, 70 percent were problem-free after a year.

Dr. Hambrecht is 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 researchers agreed that likely would be the case.

An angioplasty “only opens up one vessel blockage,” said Christopher Cannon, an associate professor of medicine at Harvard University and a spokesman for the American College of Cardiology. He was not linked to Dr. 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 eliminates waste material faster. Exercise also lowers blood pressure and prevents plaque buildup in the arteries.

Previous research has estimated that one-third of heart disease and stroke could be prevented if patients did 2 1/2 hours of brisk walking every week. In the U.S., that would mean 280,000 fewer heart-related deaths a year.

Joep Perk, a professor of health sciences at Sweden’s Kalmar University and a spokesman for the European Society of Cardiology, said two-thirds of heart patients in line for an angioplasty probably could get better benefits by regularly working up a sweat.

Researchers say fewer than 20 percent of heart patients get the recommended amount of exercise - about 30 minutes of moderate activity five times a week.

Dr. Perk said doctors who performed angioplasties on their patients without asking them to change their lifestyles were ignoring the fundamental problem. “It would be like getting rid of the most troubled rust spots on a car without doing anything to stop more rust from appearing tomorrow.”

Still, doctors said that persuading patients to exercise instead of simply undergoing an angioplasty, which can take less than a day, would be a tough sell.

“Most patients want the quick fix,” Dr. Cannon said. Exercise may improve patients’ hearts better than an angioplasty, but it may also take months or even longer for patients to feel the benefits. “It’s a lot easier to get your artery fixed than it is to exercise every day.”

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