Clinical effects of one-year physical training program in arterial hypertension patients of working age who have suffered acute myocardial infarction (Russian randomized controlled trial)

Aim. To study the effectiveness of long-term physical training of moderate intensity in patients with arterial hypertension working age who have suffered acute myocardial infarction in the framework of the Russian randomized trial.Materials and methods. The study included 206 patients with arterial hypertension after acute myocardial infarction (not earlier than 3 weeks from the event). Patients were randomized into 2 groups: basic group 102 and control 104. All patients received standard medical therapy. In the main group used physical training in a mode of medium intensity (50-60% power during a load test) 3 times a week for 1 year. The effectiveness of the intervention was assessed by clinical data and results of instrumental and laboratory analysis.Results. After a year of physical training in patients with arterial hypertension after acute myocardial infarction, there was a significant increase in physical performance by increasing the load duration (38%; p <0.001) and total volume of performed physical work (89.7 per cent; p <0,001) on the background of decreasing load magnitude a double of the work (8.2%); p <0.01. This was accompanied by a significant increase in ejection fraction of the left ventricle by 7.6% ( p <0.001) and stroke volume of the heart by 5.1% ( p <0.01). In the control group was not noted positive developments, in contrast, showed a significant increase in the left atrium (4.3%, p <0.05) on the absence of dynamics of indicators of physical performance. Under the effect of physical training decreased blood pressure levels: systolic blood pressure -3.1% ( p <0.05) and diastolic blood pressure by 3.5% ( p <0.001) against the increase in the group natrenirovavshit patients (3.1%; p <0.05; and 3.4%; p <0.05 respectively). Physical exercise exerted anti-ischemic effect, which is manifested in the reduction of episodes of myocardial ischemia, including silent, and of angina attacks and consumption of nitroglycerin unlike patients of the control group. The trained patients showed a significant decrease in the primary endpoint of 50% ( p <0.05) and disability days (by 43.2%; p <0.05) against the control group.Conclusion. Long-term (one year) of physical exercise of moderate intensity in patients with arterial hypertension complicated by acute myocardial infarction, conducted on III outpatient phase of cardiac rehabilitation provides a stable course of the disease, reduce the risk of cardiovascular complications, improve the patient's quality of life and are safe in the vast majority.

arterial hypertension, myocardial infarction, rehabilitation, physical exercise, quality of life

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