What do you advice a patient with single vessel CAD with milder forms of angina or no angina ?
Medical management ? May be you are right . But most of us do not follow this correct advice. Why ? We have a inherent bias against medical management . Cath labs exude unmatched glamor and attraction in various forms to both cardiologists and their patients. Now , here is a surprise finding , unpalatable though , for many of us ! Simple jogging or bicycling can have equal if not more relief than even a angioplasty . This study which came in 2004 was made sure , not to gain a prominent place in cardiology literature.
Let me pedal faster . . . cardiologists are after me !
The circulation article
How does exercise help in reversing CAD ?
We know the prerequisite for plaque formation is the endothelial injury along with lipid accumulation. Further , high local adrenergic(vasomotor) tone , growth factors and inflammatory activity would accelerate the plaque formation.
Regular exercise has been convincingly shown to improve the endothelial function. It restores the optimal adrenegric tone in the coronary micro circulation so the blood flow is brisk and pro-coagulant activity is reduced .
It is easy to accept the fact , exercise can prevent progression of plaque . . .A question that lingers in many including many cardiologists is this . . .How is it possible for exercise to regress well established plaques ?
When exercise can dissolve huge fat loaded abdominal tummy in matter of weeks , there need not be any doubt about the efficacy of exercise in regressing minute lipid laden coronary tummies (also called as plaques) .
(Of course , the above statement is supported by documented angiographic evidence as well !) Read below and also the AVERT study .
Final message
Attention all CAD patients , empower yourself , you can become your own cardiologist . You can perform angioplasties with bicycle at zero cost , of course you have to pay for the bicycle !
This article “hypes up” the importance of physical activity in the management of CAD. But , it has to be combined with optimal anti anginal drugs, good lipid control , blood pressure and diabetes control if present , stress reduction and good sleep to keep the CAD and cardiologists at bay !
Dr.S.Venkatesan MD 