Effects of exercise-based cardiac rehabilitation on cardiorespiratory fitness: A meta-analysis of UK studies

Almodhy, Meshal; Ingle, Lee; Sandercock, Gavin

doi:10.1016/j.ijcard.2016.06.101

Cited by 18 publications

(15 citation statements)

References 46 publications

(70 reference statements)

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“…There was a 23% decrease in risk of all‐cause mortality and a 35% decrease in risk of CVD mortality associated with CR. These effects are slightly larger than those in other studies, which generally demonstrate that CR is associated with a 20% decrease in all‐cause mortality and a 25% decrease in CVD mortality . It is certainly feasible that CR would be particularly effective in this cohort.…”

Section: Discussionmentioning

confidence: 61%

“…These effects are slightly larger than those in other studies, which generally demonstrate that CR is associated with a 20% decrease in all-cause mortality and a 25% decrease in CVD mortality. 4,[37][38][39] It is certainly feasible that CR would be particularly effective in this cohort. SCCS participants have high burdens of cardiovascular risk factors and low income and educational levels.…”

Section: Discussionmentioning

confidence: 99%

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Association of Neighborhood Socioeconomic Context With Participation in Cardiac Rehabilitation

Bachmann

Huang

Gupta

et al. 2017

JAHA

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BackgroundCardiac rehabilitation (CR) is underutilized in the United States, with fewer than 20% of eligible patients participating in CR programs. Individual socioeconomic status is associated with CR utilization, but data regarding neighborhood characteristics and CR are sparse. We investigated the association of neighborhood socioeconomic context with CR participation in the SCCS (Southern Community Cohort Study).Methods and ResultsThe SCCS is a prospective cohort study of 84 569 adults in the southeastern United States from 2002 to 2009, 52 117 of whom have Medicare or Medicaid claims. Using these data, we identified participants with hospitalizations for myocardial infarction, percutaneous coronary intervention, or coronary artery bypass surgery and ascertained their CR utilization. Neighborhood socioeconomic context was assessed using a neighborhood deprivation index derived from 11 census‐tract level variables. We analyzed the association of CR utilization with neighborhood deprivation after adjusting for individual socioeconomic status. A total of 4096 SCCS participants (55% female, 57% black) with claims data were eligible for CR. CR utilization was low, with 340 subjects (8%) participating in CR programs. Study participants residing in the most deprived communities (highest quintile of neighborhood deprivation) were less than half as likely to initiate CR (odds ratio 0.42, 95% confidence interval, 0.27–0.66, P<0.001) as those in the lowest quintile. CR participation was inversely associated with all‐cause mortality (hazard ratio 0.77, 95% confidence interval, 0.60–0.996, P<0.05).ConclusionsLower neighborhood socioeconomic context was associated with decreased CR participation independent of individual socioeconomic status. These data invite research on interventions to increase CR access in deprived communities.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Association of Neighborhood Socioeconomic Context With Participation in Cardiac Rehabilitation

Bachmann

Huang

Gupta

et al. 2017

JAHA

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“…In over 5,500 patients with heart failure, greater improvements in CRF were observed following high intensity exercise (≥ 9 METs) when compared with moderate (3)(4)(5)(6) METs) or vigorous (6-9 METs) intensities 12 . There is also a positive association between the number of exercise sessions completed and change in CRF 13 .…”

Section: Introductionmentioning

confidence: 90%

What is the effect of aerobic exercise intensity on cardiorespiratory fitness in those undergoing cardiac rehabilitation? A systematic review with meta-analysis

et al. 2018

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“…The perception of exercise as medicine has been discussed in relation to health conditions such as cognitive decline (e.g., Nagamatsu et al, 2014), cancer (e.g., Lin et al, 2016), cardiac rehabilitation (e.g., Almodhy et al, 2016), schizophrenia (e.g., Firth et al, 2015), alcohol use disorders (e.g., Hallgren et al, 2017), and all-cause mortality (e.g., Eklund et al, 2016). One meta-epidemiological study on mortality outcomes concluded that in a number of health conditions, such as heart failure, stroke, and diabetes, exercise and various pharmacological treatments are similar in their potential to extend longevity (Naci and Ioannidis, 2013).…”

Section: Introductionmentioning

confidence: 99%

Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based?

Netz

2017

Front. Pharmacol.

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Major depression disorder is most commonly treated with antidepressants. However, due to their side effects clinicians seek non-pharmacologic options, and one of these is exercise. The literature on the benefits of exercise for depression is extensive. Nevertheless, two recent reviews focusing on antidepressants vs. other therapies as a basis for clinical practice guidelines recommended mainly antidepressants, excluding exercise as a viable choice for treatment of depression. The aim of this perspective is to analyze the literature exploring the reasons for this discrepancy. Two categories of publications were examined: randomized controlled trials (RCTs) and meta-analyses or systematic reviews. Based on this reassessment, RCTs comparing exercise to antidepressants reported that exercise and antidepressants were equally effective. RCTs comparing exercise combined with antidepressants to antidepressants only reported a significant improvement in depression following exercise as an adjunctive treatment. Almost all the reviews examining exercise vs. other treatments of depression, including antidepressants, support the use of exercise in the treatment of depression, at least as an adjunctive therapy. The two reviews examining pharmacologic vs. non-pharmacologic therapies as a basis for clinical practice guidelines examined limited evidence on exercise vs. antidepressants. In addition, it is possible that academics and health care practitioners are skeptical of viewing exercise as medicine. Maybe, there is a reluctance to accept that changes in lifestyle as opposed to pharmacological treatment can alter biological mechanisms. Longitudinal studies are needed for assessing the effectiveness of exercise in real clinical settings, as well as studies exploring dose-response relationship between exercise and depression.

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Effects of exercise-based cardiac rehabilitation on cardiorespiratory fitness: A meta-analysis of UK studies

Cited by 18 publications

References 46 publications

Association of Neighborhood Socioeconomic Context With Participation in Cardiac Rehabilitation

Association of Neighborhood Socioeconomic Context With Participation in Cardiac Rehabilitation

What is the effect of aerobic exercise intensity on cardiorespiratory fitness in those undergoing cardiac rehabilitation? A systematic review with meta-analysis

Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based?

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