Impact of Cardiac Rehabilitation on Coronary Risk Factors, Inflammation, and the Metabolic Syndrome in Obese Coronary Patients

Carl J. Lavie MD, Ali Morshedi-Meibodi MD, Richard V. Milani MD
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引用次数: 63

Abstract

Obesity is a coronary heart disease (CHD) risk factor and is prevalent in patients with CHD. The authors reviewed data in 235 consecutive patients before and after formal cardiac rehabilitation and exercise training (CRET) programs and analyzed data in 72 lean patients (body mass index [BMI] <25 kg/m 2 ) vs 73 obese patients (BMI≥30 kg/m 2 ). At baseline, obese patients were significantly younger (P<.0001); had higher percentage of body fat (P<.0001) and more dyslipidemia, including higher triglycerides (TG; P<.01), lower high-density lipoprotein (HDL) cholesterol (P<.0001), and higher TG/HDL ratio (P<.0001); and had higher prevalence of metabolic syndrome (61% vs 26%; P<.01) compared with lean patients. Following CRET, obese patients had small, but statistically significant, improvements in obesity indices, including weight (P<.01), BMI (P<.01), and percentage of fat (P=.03), and had more significant improvements in peak exercise capacity (P<.001), HDL cholesterol (P<.001), C-reactive protein (P<.01), behavioral characteristics, and quality of life (P<.0001). The prevalence of metabolic syndrome fell (62% to 51%; P=.1). These results support the benefits of CRET to reduce overall risk in obese patients with CHD.

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心脏康复对肥胖冠状动脉患者冠状动脉危险因素、炎症和代谢综合征的影响
肥胖是冠心病的危险因素,在冠心病患者中普遍存在。作者回顾了235名连续患者在正式心脏康复和运动训练(CRET)项目前后的数据,并分析了72名瘦患者的数据(体重指数[BMI]<;25 kg/m2)与73例肥胖(BMI≥30kg/m2)患者比较。在基线时,肥胖患者明显更年轻(P<;.0001);具有更高的体脂百分比(P<;.0001)和更多的血脂异常,包括更高的甘油三酯(TG;P<;.01)、更低的高密度脂蛋白(HDL)胆固醇(P<).0001和更高的TG/HDL比率(P<!.0001);并且与瘦患者相比具有更高的代谢综合征患病率(61%对26%;P<;.01)。CRET后,肥胖患者的肥胖指数(包括体重(P<;.01)、BMI(P<)和脂肪百分比(P=.03))略有改善,但具有统计学意义,并且在峰值运动能力(P<!.001)、高密度脂蛋白胆固醇,代谢综合征的患病率下降(62%至51%;P=.1)。这些结果支持CRET在降低肥胖CHD患者的总体风险方面的益处。
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