Exercise Maintains Elders' Helpful Angina ResponseNovember 1, 2001 By Melissa Schorr
NEW YORK (Reuters Health) - Physical activity may help elderly patients retain a preconditioning response produced prior to a heart attack that seems to offer some protection against death, Italian researchers report.
Previous research has shown that in some cases, patients who suffer angina--chest pain due to an insufficient supply of blood and oxygen to the heart--shortly before a heart attack seem to have better chance of surviving.
Doctors theorize this may be because the heart becomes preconditioned in some way to surviving without oxygen for a short period of time. "The heart is 'vaccinated' against a more prolonged insult such as a (heart attack)," explained Dr. Pasquale Abete, the study's lead author and an assistant professor of internal medicine at the University of Naples, Italy, in an interview with Reuters Health.
Studies show that aging reduces the protective effect of this preconditioning, Abete noted.
To investigate whether exercise could extend angina's protective effects, Abete and his colleagues followed 510 elderly patients who had had an acute heart attack. All were asked whether they had suffered angina for a half-hour in the 24-hour period before the attack. They were also evaluated for their level of physical activity.
The group that exercised the most and suffered angina before their heart attack had a significant reduction in their chance of death compared with the group that did not exercise but suffered angina, the researchers report in the November 1st issue of the Journal of the American College of Cardiology.
In elderly patients who had experienced preconditioning angina prior to having their acute heart attacks, in-hospital death progressively decreased from 35% to 4% as physical activity increased, Abete said.
However, those who exercised but did not suffer angina before their attack saw no improved rate of mortality.
"The protective effect of angina is preserved in elderly patients with a high level of physical activity," Abete and colleagues conclude.
"For the aging heart to reap the benefit of...angina, the patient needs to stay physically active," Dr. Robert A. Kloner of the Heart Institute in Los Angeles, California, noted in an accompanying editorial. "Here is yet another reason to remain physically fit."
SOURCE: Journal of the American College of Cardiology 2001;38:1357-1365,