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Clinical Investigations: Cardiology/ExerciseEffects of Cardiac Rehabilitation and Exercise Training in Obese Patients With Coronary Artery Disease
Section snippets
Patients
We reviewed data in 314 consecutive patients (160 from Massachusetts General Hospital and 154 from Ochsner Medical Institutions) who were referred to, attended, and completed outpatient phase 2 cardiac rehabilitation and exercise training programs. A subgroup of 116 patients were classified as obese by body mass index (BMI) criteria (BMI ≥27.8 kg/m2 in men and ≥27.3 kg/m2 in women) as previously described.23 These obese patients were compared with the 198 patients not classified as obese. All
RESULTS
The effects of cardiac rehabilitation and exercise training in the entire cohort are demonstrated in Table 1. Following cardiac rehabilitation, significant improvements were noted in triglycerides (–11%; p<0.0001), HDL-C (+7%; pcO.OOOl), LDL-C/HDL-C ratio (-9%; pcO.OOOl), BMI (-1.5%; p<0.0001), body fat (–6%; p<0.0001), and exercise capacity (+31%; pcO.OOOl). Improvements in total cholesterol (-2%; p=0.05), LDL-C (-3%; p=0.07), and weight (-1%; p<0.07) were of borderline statistical
DISCUSSION
Limited data are available regarding the effects of cardiac rehabilitation and exercise training in obese patients with CHD. The present report demonstrates modest but significant improvements in obesity indices, plasma lipids, and exercise capacity in a large cohort of obese coronary patients. However, although obese patients had statistically greater relative improvement in indices of obesity following cardiac rehabilitation programs than nonobese patients, they had significantly less
ACKNOWLEDGMENTS
The authors greatly appreciate the technical expertise of Barbara Broussard and Lauren Oddo, who prepared and edited the submitted manuscript, as well as the medical staffs of the cardiac rehabilitation programs at both Massachusetts General Hospital and Ochsner Medical Institutions.
REFERENCES (36)
- et al.
Cardiovascular adaptation to obesity and hypertension
Chest
(1986) - et al.
Effect of weight loss on cardiac chamber size, wall thickness, and left ventricular function in morbid obesity
Am J Cardiol
(1985) - et al.
Cardiovascular rehabilitation: status, 1990
Mayo Clin Proc
(1990) - et al.
Benefits of cardiac rehabilitation and exercise training in secondary coronary prevention in the elderly
J Am Coll Cardiol
(1993) - et al.
Effects of cardiac rehabilitation and exercise training on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in women
Am J Cardiol
(1995) - et al.
Cardiac rehabilitation participation predicts lower rehospitalization costs
Am Heart J
(1992) Economic costs of obesity
Am J Clin Nutr
(1992)- et al.
Effects of cardiac rehabilitation and exercise training to improve low-density lipoprotein cholesterol in patients with hypertryglyceridemia and coronary artery disease
Am J Cardiol
(1994) - et al.
Limitations of estimating metabolic equivalents in exercise assessment in patients with coronary artery disease
Am J Cardiol
(1995) - et al.
Risk for developing cardiovascular risk factors: obesity
Cardiol Clin
(1986)
Left ventricular hypertrophy-its relationship to obesity and hypertension
Postgrad Med
Regression of increased left ventricular mass by antihypertensives
Drugs
Insulin resistance, hyperinsulinemia, dyslipidemia and cardiovascular disease
Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart study
Circulation
A prospective study of obesity and risk of coronary heart disease in women
N Engl J Med
Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise
N Engl J Med
Changes in lipoprotein subfractions during diet-induced and exercise-induced weight loss in moderately overweight men
Circulation
What do muscles have to do with lipoproteins?
Circulation
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Presented in part at the Annual Scientific Assembly of the American Association of Cardiovascular and Pulmonary Rehabilitation, Orlando, Fla, October 1993.
revision accepted June 21.