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Should high-intensity exercise be considered among CHD patients?

Comment by Patrick Doherty, EACPR Cardiac Rehabilitation Section

Cardiovascular Risk of High- Versus Moderate-Intensity Aerobic Exercise in Coronary Heart Disease Patients
Ø. Rognmo et al.
Circulation, Published online before print August 9, 2012, doi: 10.1161/?CIRCULATIONAHA.112.123117


This study gives a timely and encouraging account of the likelihood of a cardiac event associated with modern exercise programmes which, although similar to the work by Franklin et al. (1) on risk categories, it adds a new dimension through sub group analysis of moderate and high-intensity exercise.

It is clear that CR exercise remains relatively safe, in respect of the number of events expressed as a proportion of the number of exercise hours, and there is no reason to think that tailored exercise carries a high cardiac event risk.

The authors concluded that high-intensity exercise is safe and should be considered among CHD patients however a degree of caution is still required as there remains a 5 times greater risk of an event for higher-intensity exercise compared to moderate-intensity exercise.

More prospective research is needed to identify which factors predispose patients to greater risk during high-intensity exercise.

(1) Safety of Medically Supervised Outpatient Cardiac Rehabilitation Exercise Therapy, A 16-Year Follow-up
B.A. Franklin et al.
CHEST 1998; 114:902-906