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Best advice for heart failure patients: Get up and move

Everyday activities such as walking and climbing stairs can become very difficult for heart failure patients, but getting up and moving may be exactly what these patients need most.

Dr. Rami Doukky, Chairman of Cardiology at the Cook County Health & Hospitals System, has studied the impact of inactivity on patients with heart failure. He says physical activity is associated with significant improvement in survival, while a sedentary lifestyle significantly increases the risk of death.

"Our study found that heart failure patients who watch TV for more than 4 hours a day have a 65% increased risk of death compared to those who watch less than two hours a day," said Dr. Doukky. "There is nothing particularly toxic about TV, it is the prolonged sedentary activity."

Heart failure is a chronic condition in which the heart is ineffective in pumping enough oxygen-rich blood throughout the body. Patients with heart failure may suffer fatigue, shortness of breath, coughing and loss of appetite; symptoms that can make physical activity and exercise seem like an insurmountable chore.

Dr. Doukky recommends heart failure patients complete 30 to 40 minutes of exercise at least four days a week. The intensity varies depending on the patient and is typically individualized based on their exercise tolerance and their heart rate response during specialized stress testing.

"Regular exercise improves the function of the heart and can improve heart failure symptoms. More importantly, our study showed that even modest physical activity and avoiding prolonged periods of inactivity can improve their survival," said Dr. Doukky.

The study, published in the American Journal of Cardiology, analyzed data from more than 900 participants in the Heart Failure Adherence and Retention Trial (HART). It found that modest exercise of less than 90 minutes a week was associated with a significant reduction in the rate of death.

"Any walking, even a leisurely stroll, is better than no activity. More than 120 minutes a week would ideal. But any is better than none," said Dr. Doukky.

According to Dr. Doukky, encouragement for patients with heart failure to exercise either with cardiac rehabilitation or otherwise should be part of routine care.

The American Heart Association offers these tips to incorporate physical activity into everyday life:

• Start slowly - don't overdo it.

• Choose activities you enjoy

• Do a variety of activities to prevent boredom

• Try to exercise the same time each day so that it becomes a habit

• Use the buddy system. Ask a friend to join you.

The study is part of the Rush Center for Urban Health Equity, a center established by the Department of Preventive Medicine at Rush University Medical Center; and was funded by the National Institute for Heart Lung and Blood. CCHHS is a principal academic affiliate of Rush and proud to be a leading partner in medical education and research.

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