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Differential Improvements in Lipid Profiles and Framingham Recurrent Risk Score in Patients With and Without Diabetes Mellitus Undergoing Long-Term Cardiac Rehabilitation

Carroll, Sean; Tsakirides, Costas; Hobkirk, James; Moxon, James W. D.; Dudfield, Michael; Ingle, Lee


James W A Moxon

James W.A. Moxon

James W.D. Moxon

Costas Tsakirides

James W. D. Moxon

Michael Dudfield


OBJECTIVE: To determine whether lipid profiles and recurrent coronary heart disease (CHD) risk could be modified in patients with and without diabetes mellitus undergoing long-term cardiac rehabilitation (CR). DESIGN: Retrospective analysis of patient case records. SETTING: Community-based phase 4 CR program. PARTICIPANTS: Patients without diabetes (n=154; 89% men; mean ± SD age, 59.6 ± 8.5y; body mass index [BMI], 27.0 ± 3.5 kg/m²) and patients with diabetes (n=20; 81% men; mean age, 63.0 ± 8.7y; BMI, 28.7 ± 3.3 kg/m²) who completed 15 months of CR. INTERVENTIONS: Exercise testing and training, risk profiling, and risk-factor education. MAIN OUTCOME MEASURES: Cardiometabolic risk factors and 2- to 4-year Framingham recurrent CHD risk scores were assessed. RESULTS: At follow up, a significant main effect for time was evident for decreased body mass and waist circumference and improved low-density lipoprotein cholesterol (LDL-C) level and submaximal cardiorespiratory fitness (all P less than .05), showing the benefits of CR in both groups. However, a significant group-by-time interaction effect was evident for high-density lipoprotein cholesterol (HDL-C) level and total cholesterol (TC)/HDL-C ratio (both P less than .05). TC/HDL-C ratio improved (5.0±1.5 to 4.4±1.3) in patients without diabetes, but showed no improvement in patients with diabetes (4.8±1.6 v 4.9±1.6). CONCLUSIONS: We showed that numerous anthropometric, submaximal fitness, and cardiometabolic risk variables (especially LDL-C level) improved significantly after long-term CR. However, some aspects of cardiometabolic risk (measures incorporating TC and HDL-C) improved significantly in only the nondiabetic group.

Journal Article Type Article
Publication Date 2011-09
Print ISSN 0003-9993
Electronic ISSN 1532-821X
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 92
Issue 9
Pages 1382-1387
Keywords Cardiac rehabilitation; Cardiometabolic risk; Cardiorespiratory fitness; Exercise training; High-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; Rehabilitation; Type 2 diabetes
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