Stable angina

There have been few studies on exercise and this group of patients compared to other cardiac groups. One of the first studies to investigate exercise in angina patients was by Todd, et al. (1991). They found that habitual exercise had an anti-anginal effect, with the subjects experiencing up to 34% reduction in ischaemia. The authors hypothesised that exercise training enhanced myocardial collateral function. Kligfield, et al. (2003) further suggested that sustained habitual exercise in this patient group enhances the parasympathetic tone of the heart. A review of literature by the Scottish Intercollegiate Guideline Network (SIGN, 2002) examining CR and patients with stable angina found that this patient group should be considered for CR if they have limiting symptoms. Angina patients appropriate for exercise-based CR may be those who are not suitable for revascularisation and/or have an anginal threshold of 4 METs or more (ACSM, 2000). The aim of exercise is to raise the ischaemic threshold and thus allow patients to exercise more before their angina occurs. In addition, efficent use of anti-anginal medication can help this group to carry out more exercise (Durstine and Moore, 2003).

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