Prof. Denis Clement,
When approaching the treatment of cardiovascular disorders, cardiologists can use drug treatment as well as interventional and surgical treatments. However, in many cases there is also the possibility to help by lifestyle adaptation. Experience shows that this part of treatment often is neglected. Exercise as a treatment modality is a good example. Therefore, it is more than appropriate to include the session “Exercise – from leisure activity to a therapeutic option” in the ESC 2010 programme. The three first speakers defined some of the good indications for exercise treatment. Hypertension can be controlled at least partially by exercise. One of the best European experts in this field is Professor Fagard from Leuven who showed that the magnitude of the blood pressure decrease is small but consistent. Also, patients following such exercise treatment become more attentive to their control of risk factors and other aspects of lifestyle. In a second presentation, the possibility for using exercise treatment in heart failure was described. Significant increases in walking capacity were shown. However, great care is needed during exercise, with slowly increasing exercise intensity after warm up. Angina pectoris is a third good example offering quite remarkable results. The exercise needs to be supervised as well, certainly in the beginning, remaining below the level that brings on angina. In the three presentations, the mechanisms of the beneficial effects of exercise were summed up: decrease in inflammation, improvement of endothelial function, decrease in arterial stiffening, improvement in sympathetic nerve function: all play a role and most likely many other mechanisms still have to be elucidated. In the last presentation the modalities and practical applications of exercise were explained. The whole session was very appealing to a large audience. The topic is of great clinical and practical importance. Exercise therapy offers a quite pleasant alternative treatment form bringing in a number of cases as good and objective results as interventional treatment. Moreover, exercise therapy obviously does not exclude conventional therapy. Not discussed in the session are the clear positive effects exercise brings on the patients’ mental state, which gives them hope for improvement in quality of life. When done in-group, a person-to-person link is created with the members of the group that helps to solve the daily problems of the patients. Finally, exercise therapy is often much cheaper than most other treatment forms. Cardiologists should not forget to use the wide range of favourable effects exercise therapy can offer.
Exercise - from leisure activity to a therapeutic option
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