Heart attack patients who take part in a lifestyle improvement programme feel better -- especially when they do additional physical activity. That's the finding of a large study presented today on ACVC Essentials 4 You, a scientific platform of the European Society of Cardiology (ESC).

"Exercise improves fitness, which has both physical and mental health benefits," said study author Dr. Ben Hurdus of the University of Leeds, UK. "If you're more able to participate in activities that bring you happiness, then you're more likely to have a better quality of life."

Heart attack patients are typically offered lifestyle classes -- called cardiac rehabilitation -- unless they have a particular reason why it's not suitable for them. Classes include exercise, smoking cessation, advice on diet and stress management, and the importance of taking medications.

This study investigated the impact of those classes on how heart attack patients feel about their physical and mental health (collectively termed 'health-related quality of life'). Heart attacks have a detrimental effect on quality of life, including problems with mobility, self-care, and daily activities which many people take for granted such as work and leisure.

Previous research has shown a link between cardiac rehabilitation and improved quality of life in heart attack patients. However, most of these studies were conducted prior to modern drugs and procedures such as statins to lower 'bad' cholesterol and stents to open clogged arteries.

The EMMACE-3 study recruited 4,570 patients who were admitted to 48 hospitals across England with suspected heart attack in 2011 to 2013. Patients completed a questionnaire while in hospital and then at 1, 6, and 12 months after discharge. Questions included whether they attended cardiac rehabilitation, their perceived quality of life, and their physical activity levels.

Patients who attended cardiac rehabilitation had a higher quality of life at all time points compared to those who did not. Patients who went to cardiac rehabilitation and exercised 150 minutes or more per week had even higher quality of life scores compared to those who did neither.

Dr. Hurdus said: "Cardiac rehabilitation involves not only exercise but also advice on lifestyle and medications which likely all contribute to making people feel better. There are also the added social benefits such as being around other people in a similar situation and having that shared sense of community. People who also do more than the recommended minimum of 150 minutes of activity per week report even higher quality of life."

Professor Chris Gale, senior author from the University of Leeds concluded: "All heart attack patients should be referred for cardiac rehabilitation unless their healthcare professional advises against it. If it isn't discussed, speak to your local healthcare professional to see if is suitable for you."