The effect of the cardiac rehabilitation program on obese and non-obese females with coronary heart disease

Fatemeh Esteki Ghashghaei, Masoumeh Sadeghi, Samaneh Mostafavi, Hossein Heidari, Nazal Sarrafzadegan, Fatemeh Esteki Ghashghaei, Masoumeh Sadeghi, Samaneh Mostafavi, Hossein Heidari, Nazal Sarrafzadegan

Abstract

Introduction: Obesity is strongly associated with coronary heart disease and it is known as an independent risk factor. So, the aim of this study was to investigate the effects of phase II comprehensive cardiac rehabilitation program on obesity indexes, functional capacity, lipid profiles, and fasting blood sugar in obese and non-obese female patients with coronary heart disease and to compare changes in these groups.

Materials and methods: Two hundred and five women with coronary heart disease participated in our study. At the beginning of study, body mass index, functional capacity, and lipid profiles and fasting blood sugar were evaluated; then, these patients were divided into two groups, patients who had BMI≥30 were known as obese and who had BMI<30 were known as non-obese patients. All of them completed the period of cardiac rehabilitation program, and 2 months later, all risk factors were examined for the second time in each group. Data were analyzed with SPSS software version 15. For comparing the mean of outcomes, independent t-tests and paired t-tests were used.

Results: Data revealed that unless in weight (P=0.00) and functional capacity (P=0.001), there were no significant differences in obese and non-obese female patients, at baseline. As a result of the cardiac rehabilitation program, both groups had significant improvement in functional capacity (P=0.00), weight reduction (P=0.00), triglyceride (P=0.01 and P=0.02, respectively), low-density lipoprotein cholesterol (P=0.01), and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (P=0.00 and P=0.003, respectively). As well, significant improvement was observed in high-density lipoprotein (P=0.01) only in obese female, and non-obese female had significant differences in total cholesterol (P=0.003). However, there were not significant changes in total cholesterol (P=0.05) and fasting blood sugar (P=0.09) in obese female. Also, non-obese females didn't have favorable differences in high-density lipoprotein cholesterol (P=0.23) and fasting blood sugar (P=0.13). In addition, comparing two groups didn't show any significant differences in each risk factors except BMI (P=0.03).

Conclusion: Our study revealed that comprehensive cardiac rehabilitation program results in significant improvement in cardiovascular risk factors and functional capacity at all levels of BMI in female with coronary heart disease.

Keywords: Cardiac heart disease; obesity; risk factor.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Lavie CJ, Milani RV. Effects of cardiac rehabilitation and exercise training in obese patients with coronary artery disease. Chest. 1996;109:52–6.
    1. Lavie C, Milani RV. Effects of cardiac rehabilitation, exercise training, and weight reduction on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in obese coronary patients. Am J Cardiol. 1997;79:397–401.
    1. Lavie CJ, Milani RV. Obesity and cardiovascular disease: The hippocrates paradox? J Am Coll Cardiol. 2003;42:677–9.
    1. Bahrami H, Sadatsafavi M, Pourshams A, Kamangar F, Nouraei M, Semnani SH, et al. Obesity and hypertension in an Iranian cohort study; Iranian women experience higher rates of obesity and hypertension than American women. BMC Public Health. 2006;6:158.
    1. Ades AP, Savage DP, Toth JM, Harvey-Berino J, Schneider JD, Bunn JY, et al. High-Calorie-Expenditure Exercise: A New Approach to Cardiac rehabilitation for overweight coronary patients. Circulation. 2009;119:2671–8.
    1. Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S, et al. Body fat distribution and risk of coronary heart disease in men and women in the european prospective investigation into cancer and nutrition in Norfolk Cohort: A population-based prospective study. Circulation. 2007;116:2933–2943.
    1. Poirier P, Giles DT, Bray AG, Hong Y, Stern SJ, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: Pathophysiology, evaluation, and effect of weight loss: An update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the obesity committee of the council on nutrition, physical activity, and metabolism. Circulation. 2006;113:898–918.
    1. Tanaka K, Kodama H, Sasazuki S, Yoshimasu K, Liu Y, Washio M, et al. Obesity, body fat distribution and coronary atherosclerosis among Japanese men and women. Int J Obes. 2001;25:191–7.
    1. Ades AP, Patrick D. Savage MS, Harvey-Berino J.The Treatment of Obesity in Cardiac Rehabilitation. J Cardiopulm Rehabil Prev. 2010;30:289–98.
    1. Steki Ghashghaei F, Taghian F, Najafian J, Marandi M, Ramezani MA, Moastafavi S, et al. Effect of cardiac rehabilitation on functional capacity of patients after cardiac surgery by assessing 6-minute walking test. ARYA Atheroscler J. 2010;5:147–51.
    1. Kennedy MD, Haykowsky M, Daub B, Van Lohuizen K, Knapik G, Black B. Effects of a comprehensive cardiac rehabilitation program on quality of life and exercise tolerance in women.A retrospective analysis. Curr Control Trials Cardiovasc Med. 2003;4:1–6.
    1. Lavie CJ, Milani RV. Benefits of cardiac rehabilitation and exercise training. Chest. 2000;117:5–7.
    1. Sarrafzadegan N, Rabieib K, Kabir A, Asgary S, Tavassoli A, Khosravi AR, et al. Changes in lipid profile of patients referred to a cardiac rehabilitation program. Eur J Cardiovasc Prev Rehabil. 2008;15:467–72.
    1. Friedewald WT, Levy RI, Fridrikson DS. Estimation of concentrations of low-density lipoprotein cholesterol in plasma without use of preparative ultracentrifuge. Clin Chem. 1972;18:499–502.
    1. Manson SE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med. 1990;322:882–9.
    1. Lavie CJ, Milani RV. Patients with high baseline exercise capacity benefit from cardiac rehabilitation and exercise training programs. Am Heart J. 1994;128:1105–9.
    1. Gondoni LA, Titon AM, Nibbio F, Caetani G, Augello G, Mian O, Liuzzi A. Short-term effects of a hypocaloric diet and a physical activity programme on weight loss and exercise capacity in obese subjects with chronic ischaemic heart disease: A study in everyday practice. Acta Cardiologica. 2008;63:153–9.
    1. Mosayebi A, Haghjooy Javanmard SH, Mirmohamadsadeghi M, Rajabi R, Mostafavi S, Mansourian M. The effects of cardiac tertiary prevention program after coronary artery bypass graft surgery on health and quality of life. Int J Prev Med. 2011;2:269–74.
    1. Sadeghi M, Roohafza HR, Baghaei AM, Pourmoghaddas M, Shirani SH, Sadri GH, et al. Obesity and its association with other cardiovascular risk factors in women central Iran- women's healthy heart project. ARYA J. 2005;1:75–9.
    1. Leon SA, Franklin AB, Costa F, Balady JG, Berra AK, Stewart J, et al. An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2005;111:369–76.
    1. Lavie CJ, Milani RV, Littman AB. Benefits of cardiac rehabilitation and exercise training in secondary coronary prevention in the elderly. J Am Coll Cardiol. 1993;22:678–83.
    1. Shubair MM, Kodis J, McKelvie RS, Arthur HM, Sharma AM. Metabolic profile and exercise capacity outcomes: Their relationship to overweight and obesity in a Canadian cardiac rehabilitation setting. J Cardiopulm Rehabil. 2004;24:405–13.
    1. Brochu M, Poehlman ET, Savage P, Fragnoli-Munn K, Ross S, Ades PA. Modest effects of exercise training alone on coronary risk factors and body composition in coronary patients. J Cardiopulm Rehabil. 2000;20:180–8.
    1. Lavie CJ, Milani RV. Effects of cardiac rehabilitation and exercise training on low-density lipoprotein cholesterol in patients with hypertriglyceridemia and coronary artery disease. Am J Cardiol. 1994;74:1192–5.
    1. Binder KR, Barth J, Schmid JP, Saner H. Burden of abdominal obesity in cardiac rehabilitation patients. Swiss Med Wkly. 2011;53:131–41.
    1. Balady GJ, McInnis KJ. Cardiac rehabilitation in obese patients. Chest. 1996;109:3–4.
    1. Manzoni GM, Villa V, Compare A, Castelnuovo G, Nibbio F, Titon AM, et al. Short-term effects of a multidisciplinary cardiac rehabilitation programme on psychological wellbeing, exercise capacity and weight in a sample of obese in-patients with coronary heart disease: A practice level study. Psychol Health Med. 2011;16:178–89.

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