Exercise may help pulmonary hypertension patients

Appropriate amounts of exercise offer psychological and physical benefits for patients with severe pulmonary hypertension according to research reported in Circulation: Journal of the American Heart Association.

It is commonly believed that exercise training may be dangerous for pulmonary hypertension (PH) patients, because increasing pressure on the pulmonary arteries may worsen right-sided heart failure the study reported. However, this new research found that patients should exercise, but only in certain amounts, in addition to taking medicine. All training should be started with supervision in a hospital.

Pulmonary hypertension is a life-threatening disease that restricts physical capacity, lowers quality of life and has a poor prognosis because the heart’s upper right chamber loses its ability to pump blood to the lungs.

Although treatment of PH is advancing, researchers say adverse effects occur with the medications that treat it. Most patients continue to have symptoms, reduced physical abilities and reduced quality of life despite excellent medical treatment. Reduced exercise ability in PH is associated with depression and anxiety disorders.

Researchers evaluated the effects of exercise and respiratory training in 30 patients (21 female), average age 50, with severe chronic PH who were stable for at least three months. Patients were randomly assigned to either a control group or a primary training group and evaluated before the study, at week three and at week 15.

The control group received a common rehabilitation program, while the primary training group participated in an additional low-dose exercise program, supervised by physicians and physiotherapists, seven days a week.

Mental training helped patients realise in the early stages of exercise if they were exceeding their physical abilities. Patients often wanted to do more than they should, according to the report.

However, the results showed that exercise training in patients with severe PH is beneficial psychologically and physically.

Low-dose respiratory and exercise training may add to an optimised medical therapy. Nevertheless, for safety reasons exercise training should be started in the hospital and closely monitored in an outpatient setting. Cooperation between specialised centres for PH, rehabilitation clinics and general practitioners is necessary, the report said.