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

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

Abstract

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.

Citation

Carroll, S., Tsakirides, C., Hobkirk, J., Moxon, J. W. D., Dudfield, M., & Ingle, L. (2011). Differential Improvements in Lipid Profiles and Framingham Recurrent Risk Score in Patients With and Without Diabetes Mellitus Undergoing Long-Term Cardiac Rehabilitation. Archives of physical medicine and rehabilitation, 92(9), 1382-1387. https://doi.org/10.1016/j.apmr.2011.04.013

• Journal Article Type: Article
• Online Publication Date: Aug 27, 2011
• Publication Date: 2011-09
• Journal: ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
• Print ISSN: 0003-9993
• Electronic ISSN: 1532-821X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 92
• Issue: 9
• Pages: 1382-1387
• DOI: https://doi.org/10.1016/j.apmr.2011.04.013
• Keywords: Cardiac rehabilitation; Cardiometabolic risk; Cardiorespiratory fitness; Exercise training; High-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; Rehabilitation; Type 2 diabetes
• Public URL: https://hull-repository.worktribe.com/output/423538
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0003999311002747?via%3Dihub#!