The National Exercise and Heart Disease Project. The pre-randomization exercise program. Report number 2.

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Preventive Cardiology

Background:

• The National Exercise and Heart Disease Project (NEHDP) investigated the impact of physical activity on patients with healed myocardial infarctions.
• Funding was provided by the Rehabilitation Services Administration (RSA) to assess rehabilitation, morbidity, and mortality.
• The project spanned planning from 1972-1974, with subject enrollment beginning in 1974.

Purpose of the Study:

• To determine the effects of regular physical activity on the rehabilitation of myocardial infarction survivors.
• To evaluate the impact of exercise on morbidity and mortality in this patient population.
• To assess the long-term benefits of physical activity post-myocardial infarction.

Main Methods:

• 932 subjects were referred for evaluation, with 651 randomized into exercise (323) or control (328) groups.
• Participants underwent an initial evaluation, a 6-week low-level physical activity program (14 of 18 sessions), and a second evaluation before randomization.
• Subjects are followed for a minimum of 2 years to monitor outcomes.

Main Results:

• The pre-randomization phase showed significant improvements in work capacity.
• Resting and stress-induced heart rate levels were altered.
• Systolic blood pressure reductions occurred during physical stress, and levels of anxiety and depression decreased.

Conclusions:

• Regularly performed physical activity demonstrated positive physiological and psychological effects in the pre-randomization phase.
• Further follow-up is required to confirm long-term benefits on rehabilitation, morbidity, and mortality.
• The study design aims to provide evidence for exercise's role in cardiac recovery.