scholarly journals Is the Clinical Delivery of Cardiac Rehabilitation in an Australian Setting Associated with Changes in Physical Capacity and Cardiovascular Risk and Are Any Changes Maintained for 12 Months?

Author(s):  
Kym Joanne Price ◽  
Brett Ashley Gordon ◽  
Stephen Richard Bird ◽  
Amanda Clare Benson

Long-term maintenance of changes in cardiovascular risk factors and physical capacity once patients leave the supervised program environment have not previously been reported. This study investigated the changes in physical capacity outcomes and cardiovascular risk factors in an Australian cardiac rehabilitation setting, and the maintenance of changes in these outcomes in the 12 months following cardiac rehabilitation attendance. Improvements in mean (95% CI) cardiorespiratory fitness (16.4% (13.2–19.6%), p < 0.001) and handgrip strength (8.0% (5.4–10.6%), p < 0.001) were observed over the course of the cardiac rehabilitation program, and these improvements were maintained in the 12 months following completion. Waist circumference (p = 0.003) and high-density lipoprotein cholesterol (p < 0.001) were the only traditional cardiovascular risk factors to improve during the cardiac rehabilitation program. Vigorous-intensity aerobic exercise was associated with significantly greater improvements in cardiorespiratory fitness, Framingham risk score, and waist circumference in comparison to moderate-intensity exercise. An increase in the intensity of the exercise prescribed during cardiac rehabilitation in Australia is recommended to induce larger improvements in physical capacity outcomes and cardiovascular risk. A standardized exercise test at the beginning of the rehabilitation program is recommended to facilitate appropriate prescription of exercise intensity.

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
NPD Cunha ◽  
I Aguiar-Ricardo ◽  
T Rodrigues ◽  
S Couto Pereira ◽  
P Silverio Antonio ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular risk factors (CVRF) control, needing different strategies, through patient education, lifestyle changes and therapeutic optimization is a central core of cardiac rehabilitation. However, further studies are needed to demonstrate effectiveness of home-based Cardiac Rehabilitation (CR-HB) programs in controlling CVRF.   Purpose To evaluate the effectiveness of a CR-HB program in controlling cardiovascular risk factors. Methods Prospective cohort study including patients who were previously participating in a centre-based CR program and accepted to participate in a CR-HB program due to forced closure of the centre-based CR program for COVID-19 pandemic. The CR-HB consisted of a multidisciplinary digital CR program, including patient regular assessment, exercise, educational, and psychological and relaxation sessions. A structured online educational program for patients and family members/caregivers was provided including educational videos, and powerpoints and webinars. A real time Webinar regarding "nutritional myths and facts" was organized with the duration of 90 minutes as a substitution of the regular face-to-face regular workshop provided at our centre-based CR program. Also, self-control of blood pressure and heart rate and of glycemia in diabetics were promoted, as well as smoking cessation. To assess the impact of the CR-HB on risk factors control, all the patients were submitted to a clinical and analytical evaluation before and after the end of this at distance program.  Results 116 cardiovascular disease patients (62.6 ± 8.9 years, 95 males) who were attending a face-to-face CR program were included in a CR-HB program. Almost 90% (n = 103) of the participants had coronary artery disease. Regarding risk factors, obesity was the most prevalent risk factor (74.7 %) followed by hypertension (59.6%), family history (41.8%), dyslipidaemia (37.9%), diabetes (18.1%), and smoking (12.9%).  Regarding the blood pressure control, 80% of the patients stated that almost daily they measured blood pressure at home; baseline systolic pressure decreased from 117 ± 13 to 113 ±12mmHg, p = 0.007, while there was no significant change in diastolic pressure.   The majority (76%) of diabetic patients said they controlled blood glucose; HbA1c decreased from 6.1 ± 1.1 to 5.9 ± 0.9mg/dL (p = 0.047). Considering the lipid profile, LDL decreased (from 75 ± 30 to 65 ± 26mg/dL, p = 0.012). The Nt-proBNP also decreased (818 ± 1332 vs 414pg/ml ± 591, p = 0.042). There were no other statistically significant differences concerning risk factors modification.  Conclusions Our study showed that a Home-based Cardiac Rehabilitation program can improve or maintain cardiovascular risk factors control, which has important prognostic implications and is frequently a difficult task to achieve.


2013 ◽  
Vol 32 (3) ◽  
pp. 191-199 ◽  
Author(s):  
Sandra Magalhães ◽  
Maria Miguel Ribeiro ◽  
Ana Barreira ◽  
Preza Fernandes ◽  
Severo Torres ◽  
...  

2021 ◽  
Vol 20 (4) ◽  
pp. 422-432
Author(s):  
Ana Denise Brandão ◽  
Keila Larissa Pereira Reis ◽  
Nathalia Moraes Ribeiro ◽  
Patricia Figueiredo ◽  
Daniela Martins de Fausto ◽  
...  

Background: Metabolic syndrome is a complex disorder represented by a set of cardiovascular risk factors usually related to central fat deposition, insulin resistance, hypertension, and dyslipidemia. It is associated with accelerated atherosclerosis in response to chronic inflammation and vascular endothelial dysfunction, increasing overall mortality. Objective: We aimed to evaluate the effect of a cardiac rehabilitation program on cardiovascular risk factors in patients with metabolic syndrome. Methods: This is prospective interventional study. All patients underwent a 20-session cardiac rehabilitation program with aerobic and resisted exercises as well as an educational program for lifestyle changes. Results: Forty-seven patients participated in the present study. After the cardiac rehabilitation program (CRP), a significant reduction (p = 0,0092) for cardiovascular risk and fatigue (p > 0.001) was observed; 78% of the patients had positive effects on physical capacity, 72% of the patients presented HbA1c reduction, 51% increased HDL-cholesterol, 70% reduced total cholesterol, 63% reduced triglycerides, 61% reduced systolic blood pressure and 53% reduced diastolic blood pressure. Conclusion: Cardiac rehabilitation program with aerobic and resisted exercises associated with educational program for lifestyle changes is an effective approach in the treatment of patients with metabolic syndrome mainly seen by a reduced cardiovascular risk factors and reducing fatigue, improved physical capacity and reduced components of metabolic syndrome.


2010 ◽  
Vol 7 (6) ◽  
pp. 746-753 ◽  
Author(s):  
Soyang Kwon ◽  
Trudy L. Burns ◽  
Kathleen Janz

Background:This study aimed to examine combined and independent effects of cardiorespiratory fitness and fatness on cardiovascular risk factors among U.S. adolescents.Methods:Data from adolescents age 12 to 19 years participating in the NHANES 1999 to 2002 were used. Fitness level was determined by submaximal treadmill test and was dichotomized as ‘not fit’ or ‘fit’ according to the FITNESSGRAM. Fatness level was categorized as ‘not fat’ or ‘fat’ based on the CDC BMI growth charts. Gender-specific multivariable linear regression analyses were conducted to compare age-, race/ethnicity-, fatness-, and waist circumference-adjusted means of blood pressure, lipids, lipoproteins, C-peptide, insulin, and C-reactive protein (CRP) levels.Results:A total of 3202 adolescents (1629 boys) were included for data analysis. Among boys, total cholesterol, tri-glycerides, insulin, and CRP mean levels were significantly higher (P < .05) in the ‘not fit’ group than in the ‘fit’ group, after adjustment for fatness level and waist circumference. Among girls, the fatness level- and waist circumference-adjusted means of total cholesterol (P < .01) and LDL-C (P < .09) were higher in the ‘not fit’ than ‘fit’ groups.Conclusion:Cardiorespiratory fitness, independent of fatness, may have beneficial effects on lipid profiles among girls, and on lipid profiles, insulin metabolism, and inflammation levels among boys.


2016 ◽  
Vol 115 (9) ◽  
pp. 1586-1597 ◽  
Author(s):  
Michelle Alessandra Castro ◽  
Valéria Troncoso Baltar ◽  
Dirce Maria Marchioni ◽  
Regina Mara Fisberg

AbstractThe association between dietary patterns and metabolic cardiovascular risk factors has long been addressed but there is a lack of evidence towards the effects of the overall diet on the complex net of biological inter-relationships between risk factors. This study aimed to derive dietary patterns and examine their associations with metabolic cardiovascular risk factors following a theoretic model for the relationship between them. Participants included 417 adults of both sexes, enrolled to the cross-sectional population-based study performed in Brazil. Body weight, waist circumference, high-sensitivity C-reactive protein, blood pressure, total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio, fasting plasma glucose and serum leptin were evaluated. Food consumption was assessed by two non-consecutive 24-h dietary recalls adjusted for the within-person variation of intake. A total of three dietary patterns were derived by exploratory structural equation modelling: ‘Traditional’, ‘Prudent’ and ‘Modern’. The ‘Traditional’ pattern had a negative and direct effect on obesity indicators (serum LEP, body weight and waist circumference) and negative indirect effects on total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio and fasting plasma glucose. The ‘Prudent’ pattern had a negative and direct effect on systolic blood pressure. No association was observed for the ‘Modern’ pattern and metabolic risk factors. In conclusion, the ‘Traditional’ and ‘Prudent’ dietary patterns were negatively associated with metabolic cardiovascular risk factors among Brazilian adults. Their apparent protective effects against obesity and high blood pressure may be important non-pharmacological strategies for the prevention and control of obesity-related metabolic disorders and CVD.


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