Daily exercise may relieve chest pain

For some people, exercising 20 minutes a day could relieve chest pain more effectively than an angioplasty with stents.

German researchers studied 101 men age 70 and younger who suffered mild angina during exertion such as exercise. All were considered at low risk of heart attack because they had stable coronary artery disease and their hearts had good pumping ability.

In the study, conducted from March 1997 to March 2001 at the University of Leipzig, half the patients were randomly assigned to a daily exercise-bike regimen. The remainder underwent minimally invasive angioplasty, in which a thin balloon-tipped catheter was snaked into the blocked artery to open it and then a mesh stent was inserted. All continued their usual medications.

After a year, both groups reported an improved ability to exercise without chest pain, although the exercisers could work out at a higher intensity without pain. Although angioplasty brought more immediate relief, it was associated with complications, which in some cases meant repeat procedures.

The most significant finding was that 88% of the exercise group had no heart attacks or strokes, no cardiac bypass surgeries and didn’t die from a cardiac-related cause, compared with 70% of the angioplasty group.

Although the researchers said the study was too small to make a general recommendation, Dr. Gregg C. Fonarow, a UCLA professor of cardiovascular medicine, said it demonstrated that “the benefits of medications and lifestyle change are much more profound than recognized.”

The study was published in the March 9 online issue of Circulation: Journal of the American Heart Assn.