Impact of Cardiac Rehabilitation on Metabolic Syndrome in Iranian Patients with Coronary Heart Disease: The Role of Obesity

Abstract

Background Due to high prevalence of metabolic syndrome (MetS) and coronary heart disease (CHD) in Iran, and their mutual relationship, we evaluated how comprehensive cardiac rehabilitation (CR) can affect MetS in patients with CHD. Method In this study (1998–2003), we evaluated 547 patients with CHD undergoing comprehensive CR. Results Cases with MetS decreased from 42.8% to 33.3% after CR program (p < .001). Decrease in high fasting plasma glucose, triglyceridemia, systolic and diastolic blood pressures, and increase in HDL cholesterol, functional capacity, and left ventricular ejection fraction was more prominent in the “MetS but not obese” group. However, total cholesterol, low‐density lipoprotein, weight, body mass index, and waist circumference showed a greater decrease in groups with obesity. Conclusion Cardiac rehabilitation is an effective treatment of MetS, particularly in the absence of obesity. This represents an additional argument for the prevention of obesity and the linked insulin resistance.

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.…”

“…Data were extracted by a single reviewer (ZK) and checked by a second reviewer (ASA). Moreover, we contacted the authors of the included articles for additional unpublished data or clarification of data[182126] when necessary to ensure that all related articles were represented in the meta-analysis.…”

“…To calculate the mean changes and their corresponding standard deviations (SDs) for articles, which did not provide these data, we computed the correlation coefficient using articles that reported changes in the mean and SD of metabolic factors. [1821] Furthermore, the MetS reduction rate was calculated from pre- and post-CR prevalence in each study of MetS as an effect size to be included in the meta-analysis. Summary mean estimates with their corresponding SDs were derived by the method explained by DerSimonian and Laird[31] using random effects model, taking between-studies variability into account.…”

“…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.…”