Why Strength Training is Vital for Patients with Heart Failure

Introduction

Heart failure (HF) is a multi-faceted and life-threatening syndrome characterised by significant morbidity and mortality, poor functional capacity and quality of life (QoL), and high costs. Accordingly, reducing its social and economic burden has become a major global public health priority. The magnitude of the problem of HF cannot be assessed with precision since reliable, population-based estimates of its prevalence, incidence, and prognosis are lacking, particularly epidemiological data on HF in developing countries, where HF has different characteristics compared with the Western world, are needed. Nevertheless, there are an estimated 64 million people with HF worldwide. Although incidence has remained stable or has even slightly declined over time, prevalence is increasing due to the ageing of the population and the prolongation of the lives of cardiac patients by modern therapeutic innovations (1).

As highlighted, HF is characterised by functional limitations and consequent loss of QoL and has a significant impact on prognosis. A systematic review and meta-analysis of 44 observational longitudinal cohort studies with a total of 22,598 patients with HF showed that patients with poor physical functional performance in the Six Minute Walking Test (6MWT), the Short Physical Performance Battery (SPPB), and the Gait Speed Test had worse prognosis in terms of larger risk of hospitalisation or mortality than patients with good physical functional performance (2). Another systematic review and meta-analysis also showed a strong relationship between physical performance and prognosis among patients with HF. Six-minute walk distance (6MD) test cut-off values were significantly associated with mortality (hazard ratio [HR], 2.04; 95% CI, 1.48-2.83; p < 0.001) and cardiovascular disease (HR, 2.18; 95% CI, 1.68-2.83; p < 0.001) (3).

An old couple doing strength training for heart failure.

In my post, ‘Exercise: The Medicine Since Antiquity’, I have discussed the role exercise has played in preserving health and preventing and managing various diseases since almost 600 BC. A systematic review showed that exercise also improves functional capacity and QoL in patients with heart failure (4).

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Weight Training Program Design for Optimum Health.

Introduction

For most people, the term ‘exercise’ means aerobic activities like walking, jogging etc. The benefits of weight training (also commonly known as strength training or resistance training; the terms will be used interchangeably) are either overlooked or at best minimized to that of building muscles and improving sports performance. However, we now have a better understanding of the health-related benefits of strength training; the health benefits of enhancing muscular fitness are on par with aerobic fitness, if not more. In my post ‘Health Benefits of Exercise: a grossly underutilised therapy’, I have discussed the health benefits of muscular fitness. Keeping in view the health benefits of muscular fitness, strength training is now a popular form of exercise that is recommended by the World Health Organisation and the US national health organisations such as the American College of Sports Medicine and the American Heart Association, for most populations including adolescents, healthy adults, the elderly, and clinical populations (e.g. those individuals with cardiovascular disease, neuromuscular disease etc.).

People of various categories doing weight training.
Fig: People of various categories doing weight training
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