Cardiac Rehabilitation Programs Improve Metabolic Parameters in Patients With the Metabolic Syndrome and Coronary Heart Disease

Abstract

This study was performed to determine the effectiveness of a cardiac rehabilitation and exercise training program on metabolic parameters and coronary risk factors in patients with the metabolic syndrome and coronary heart disease. The study involved 642 patients with coronary heart disease. Of them, 171 (26.7%) fulfilled criteria for the metabolic syndrome. Clinical data, laboratory tests, and exercise testing were performed before and after the program, which lasted 2 to 3 months. Except for waist circumference, there were no significant differences between groups; blood pressure, high-density lipoprotein cholesterol, triglycerides, and fasting glucose improvements during the follow-up were higher in patients with the metabolic syndrome (all P<.001). At study end, in patients with the metabolic syndrome, functional capacity increased by 26.45% ( P<.001), as measured by metabolic equivalents, with a slight increase of 1.25% ( P=not significant) in the double product. Patients with the metabolic syndrome who took part in this secondary prevention program reported improvements in cardiovascular risk profile and functional capacity. J Clin Hypertens (Greenwich).

Effect of cardiac rehabilitation on metabolic syndrome and its components: A systematic review and meta-analysis

“…Finally, 15 articles were eligible to be included in the current systematic review (seven conducted in the US,[16181922242729] three in Canada,[232530] two in Europe,[2026] and three in Asia[172128]). In total, these studies included 19,324 MetS patients and the number of participants ranged from 32 to 15,819.…”

“…In total, these studies included 19,324 MetS patients and the number of participants ranged from 32 to 15,819. The ATP III criteria[3] were used in nine studies,[1617202122242530] whereas harmonized criteria[35] were used in two studies;[1823] the International Diabetes Federation (IDF) criteria[4] were used only in one study[26] and three studies did not report their definitions. [192829] The duration of studies was from 4 weeks to 59 weeks.…”

“…Eight studies[1618202123242530] with 2,866 subjects evaluated the effect of the CR on the recovery from MetS by reporting the decrement in MetS prevalence. We found a significant effect of CR on decreasing MetS prevalence in the whole data set [prevalence reduction (95% CI): 0.25 (0.21, 0.3), P value <0.001; P value for heterogeneity <0.001, I-squared: 86.2%]; subgroup analysis based on duration of CR (duration <10 week as short term and duration >10 weeks as long term) showed that short-term CR administration results in a greater reduction in MetS prevalence than long-term CR [prevalence reduction rate (95% CI): 0.34 (0.26, 0.43), P value < 0.001and prevalence reduction rate (95% CI): 0.24 (0.18, 0.29), P < 0.001,respectively] [Figure 2].…”

“…Ten studies[16171819202122252627] with 17,024 subjects evaluated the effect of CR on LDL-C, HDL-C, and TG, and 8 studies[1617182021222526] with 16,791 subjects evaluated the role of CR on TC. CR resulted in a significant reduction in TC, LDL-C, and TG and a significant increase in the mean HDL-C levels.…”

“…Although various studies were conducted to test the effect of CR on MetS patients, there are still inconsistent results on the effect of CR on reverse MetS and also its components. For instance, although several studies have failed to find any significant effect of CR on high density lipoprotein cholesterol (HDL-C),[161718] some others have even documented its significant effects on HDL-C.[19202122] The same pattern can be observed in other metabolic factors too. [161718192021222324252627282930] Therefore, the present article aimed to summarize and if possible, perform a meta-analysis on published data about the effect of CR on MetS reduction rate and its components or related metabolic and anthropometric markers.…”