Effects of prolonged intensive versus moderate leg training on the untrained arm exercise response in angina pectoris

To compare the effects of 2 different leg training intensities on the cardiocirculatory exercise response of the untrained arm, 58 patients with angina pectoris were randomized to either an intensive (at least 85% of symptom-limited exercise, n = 28) or a moderate (70 to 85% of symptom-limited exercise, n = 30) training group. Patients trained for 6 months, 2 times per week for 30 minutes each. Results of the 2 groups after training showed similar significant (p less than or equal to 0.001) decreases in heart rate (HR), systolic blood pressure (BP) and HR X BP product for trained legs and untrained arms at matched subanginal workloads and significant (p less than 0.01 to 0.001) increase in anginal threshold HR and HR X BP for the onset of 1 mm or more ST horizontal depression during testing of trained legs as well as of untrained arms. The improvement in exercise capacity at subanginal workloads results from decreased HR X BP product. In contrast, the significant increase in HR X BP product for the onset of ST-segment displacement and precipitation of anginal pain for both the trained and untrained limbs may imply an increase in myocardial blood flow. Thus, prolonged intensive or moderate training may significantly improve coronary blood flow in selected patients with angina pectoris. Patients with the highest anginal threshold HR and HR X BP product before training showed the most improvement at 6 months after training.