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BMJ 2009; 338 doi: (Published 14 April 2009) Cite this as: BMJ 2009;338:b1526

Exercise is safe and slightly better than usual care for people with stable heart failure

Guidelines now recommend some exercise for people with stable heart failure, instead of the traditional advice to rest, but definitive clinical data to support this recommendation have been lacking . A multicentre trial of 2331 outpatients fills the gap. Participants’ median age was 59 years: 28% were women, and 37% had New York Heart Association stage III or IV disease. During a median follow-up of 30 months, the trial compared usual care with added aerobic exercise training, which consisted of 36 supervised sessions followed by training at home.

Non-significant results favouring exercise were seen across all outcomes, which included a composite of all cause mortality or all cause hospital admission (primary outcome 65% (759/1159) v 68% (796/1172); hazard ratio 0.93, 95% CI 0.84 to 1.02; P=0.13) and several prespecified secondary outcomes—mortality (0.96, 0.79 to 1.17), cardiovascular mortality or hospital admission for cardiovascular disease …

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