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Arch Phys Med Rehabil. 2011 Sep;92(9):1382-7. doi: 10.1016/j.apmr.2011.04.013.

Differential improvements in lipid profiles and Framingham recurrent risk score in patients with and without diabetes mellitus undergoing long-term cardiac rehabilitation.

Author information

1
Leeds Metropolitan University, Leeds, UK.

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<.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<.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.

PMID:
21878208
DOI:
10.1016/j.apmr.2011.04.013
[Indexed for MEDLINE]

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