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Wake Forest to Study Effects of Exercise on Heart Failure Patients

WINSTON-SALEM, N.C. – Wake Forest University Baptist Medical Center is taking part in a $37 million national research study to determine whether an exercise program can help heart failure patients live longer.

Many studies conducted over the past decade have shown that exercise can have a positive effect on symptoms of heart failure. However, the HF-ACTION trial (Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing) is the first large-scale trial designed to determine whether exercise can reduce mortality and hospitalizations for patients with heart failure.

“In the not-too-distant past, medical textbooks admonished that patients with heart failure must rest and not undertake any vigorous physical activity. Sometimes weeks of bed rest were prescribed,” said cardiologist Dalane W. Kitzman, M.D., principal investigator of the Wake Forest study site. “As we have come to appreciate the benefits of regular exercise for coronary heart disease and high blood pressure, we’ve made the assumption that exercise is good for heart failure as well.”

Heart failure is a condition marked by the inability of the heart muscles to pump enough oxygen and nutrients in the blood to the body’s tissues. Also known as congestive heart failure, its many causes include coronary artery disease, high blood pressure, previous heart attack, valve problems or infection.

An estimated 4.7 million Americans suffer from heart failure, with 400,000 new cases reported each year, and according to researchers, it is the only cardiovascular disease that is rising in incidence. Once diagnosed with heart failure, about 50 percent of patients will die within five years.

Heart failure often leaves patients exhausted and breathless, and the normal activities of these patients can be severely restricted. While there is no cure for the disorder, a variety of drugs are often used including digoxin to improve the strength of the heartbeat; ACE inhibitors and beta-blockers to relax blood vessels; or diuretics to remove the excess buildup of fluid in the lungs.

The five-year, 3,000-patient randomized trial is sponsored by the National Heart, Lung, and Blood Institute. Ninety patients will be recruited to take part in the Wake Forest portion of the trial.

After medical histories and examinations, participants will be selected at random to receive usual care for heart failure or the usual care with the addition of exercise training. Those patients in the exercise group will be given a personalized exercise program at the Wake Forest University Cardiac Rehabilitation Center.

Co-investigator, Peter H. Brubaker, Ph.D., associate professor of health and exercise science at Wake Forest, is director of the cardiac rehabilitation program.

“For the first three months, study participants in the exercise group will exercise three times a week under supervision, using a treadmill or stationary bike,” said Brubaker. “After this initial period, they will continue their exercise program at home for three years.”

The study will provide the exercise equipment that patients will use at home.

“Without the HF-ACTION study, we would never know whether medical wisdom of the past was correct or not,” said Kitzman. “In fact, the absence of a study proving benefit is the reason that Medicare and insurance providers give for refusing to cover the cost of exercise programs for heart failure patients.”

For information about participating in the HF-ACTION study, contact Judy Brown at (336) 713-4702.

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Contact: Jim Steele jsteele@wfubmc.edu, Karen Richardson krchrdsn@wfubmc.edu, Barbara Hahn bhahn@wfubmc.edu, or Jonnie Rohrer jrohrer@wfubmc.edu, (336) 716-4587.

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