Effects of moderate physical training program in post-myocardial infarction patients with arterial hypertension.

The clinical effectiveness of physical training in a Cardiac Rehabilitation Program (CRP) was assessed in hypertensive (Arterial Hypertension, AH), post-Myocardial Infarction (MI) patients. 206 patients were randomized into a physically trained group (PhTG, n=102) and an untrained, control group (CG, n=104). All patients received standard drug therapy. PhTG patients performed mild callisthenic exercises and moderately intensive bicycle exercise three times/week for one year. Compared to control patients, PhTG patients had significant changes in exercise capacity (duration +38%, p<0.001; total work +63.6%, p<0.001); rate-pressure product (-8.2%, p<0.01); left ventricular ejection fraction (+7.6%, p<0.001); left ventricular stroke volume (+5.1%, p<0.01). Resting BP decreased in PhTG patients (systolic BP, -3.1%, p<0.05; diastolic BP, -3.5%, p<0.001), but increased in CG patients (systolic BP, +3.1%, p<0.05; diastolic BP +3.4%, p<0.05). PhTG patients had fewer myocardial ischemic episodes, including painless ischemia during exercise, fewer angina attacks, less nitroglycerin consumption, improved quality of life, fewer cardiovascular events (-50%, p<0.05), and days of absence from work (-43.2%, p<0.05). Thus, supplementing a CRP with moderate exercise improved BP, work capacity, cardiac function, and quality of life in hypertensive, post-MI patients.