Cardiovascular risk reductions associated with aggressive lifestyle modification and cardiac rehabilitation

Aldana, Steven G.; Whitmer, William R; Greenlaw, Roger L.; Avins, Andrew L.; Salberg, Audrey; Barnhurst, Megan; Fellingham, Gilbert W.; Lipsenthal, Lee

doi:10.1016/s0147-9563(03)00106-7

Cited by 109 publications

(58 citation statements)

References 20 publications

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“…There is considerable evidence that behavioral treatments reduce the risk of cardiac events and death in individuals who have heart disease (Aldana et al 2003;Billings 2000;Koertge et al 2003) as well as improve psychological wellbeing (van Dixhoorn et al 1990). Exercise, stress management and relaxation, cognitive behavioral therapy, and smoking cessation have been found to increase HRV (Stein et al 1999;van Dixhoorn et al 1990;van Dixhoorn and White 2005).…”

Section: Behavioralmentioning

confidence: 99%

The Effect of Biofeedback on Function in Patients with Heart Failure

Swanson

Gevirtz

Brown

et al. 2009

Appl Psychophysiol Biofeedback

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Decreased HRV has been consistently associated with increased cardiac mortality and morbidity in HF patients. The aim of this study is to determine if a 6-week course of heart rate variability (HRV) biofeedback and breathing retraining could increase exercise tolerance, HRV, and quality of life in patients with New York Heart Association Class I-III heart failure (HF). Participants (N = 29) were randomly assigned to either the treatment group consisting of six sessions of breathing retraining, HRV biofeedback and daily practice, or the comparison group consisting of six sessions of quasi-false alpha-theta biofeedback and daily practice. Exercise tolerance, measured by the 6-min walk test (6MWT), HRV, measured by the standard deviation of normal of normal beats (SDNN), and quality of life, measured by the Minnesota Living with Congestive Heart Failure Questionnaire, were measured baseline (week 0), post (week 6), and follow-up (week 18). Cardiorespiratory biofeedback significantly increased exercise tolerance (p = .05) for the treatment group in the high (C31%) left ventricular ejection fraction (LVEF) category between baseline and follow-up. Neither a significant difference in SDNN (p = .09) nor quality of life (p = .08), was found between baseline and follow-up. A combination of HRV biofeedback and breathing retraining may improve exercise tolerance in patients with HF with an LVEF of 31% or higher. Because exercise tolerance is considered a strong prognostic indicator, cardiorespiratory biofeedback has the potential to improve cardiac mortality and morbidity in HF patients.

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Section: Behavioralmentioning

confidence: 99%

The Effect of Biofeedback on Function in Patients with Heart Failure

Swanson

Gevirtz

Brown

et al. 2009

Appl Psychophysiol Biofeedback

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“…[26][27][28][29][30] The benefits of behavioral modification in reducing CHD events and atherosclerotic progression are well known, and these aspects are an intrinsic part of most rehabilitation programs. 29,30 Aging is normally associated with a loss of aerobic capacity, which may lead to a poorer HRQoL. A positive relationship was demonstrated between engaging in regular exercise and higher levels of functioning and a better HRQoL.…”

Section: Literature Reviewmentioning

confidence: 99%

“…The role of diet in further development of atherosclerosis has been investigated but only in relation to cardiac rehabilitation and lifestyle modification in those with CHD. 29,30 Diet can be measured using a variety of methods, such as food diaries, food frequency charts, and dietary recalls, but they tend to be poor measures of diet. 31 The long-term role of diet in CABG was not evident in the literature.…”

Section: Literature Reviewmentioning

confidence: 99%

Determinants of quality of life five years after coronary artery bypass graft surgery

Lee

2009

Heart & Lung

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“…One of the typical phenotypes associated with increased risk of CHD includes increased LDL cholesterol (LDL-C) and reduced concentrations of HDL. Several epidemiological and physiological data indicate that a change in lifestyle (diet, physical training) can significantly improve lipoprotein profile and prognosis of CHD (2,3). Meta-analysis of 60 controlled trials (4), focused on the effects of dietary FAs, clearly demonstrated a significant decrease in LDL concentration when saturated fatty acids (SFAs) in a diet were replaced with unsaturated FAs, and this decrease was accompanied by a significant decrease in HDL concentration.…”

mentioning

confidence: 99%

Replacement of dietary saturated FAs by PUFAs in diet and reverse cholesterol transport

Lesná

Suchánek

Kovář

et al. 2008

Journal of Lipid Research

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Dietary intervention is the first and usually successful approach in the treatment of high LDL cholesterol (LDL-C) concentration, but it is frequently accompanied by a decrease in HDL concentration. We studied 14 male volunteers on two different diets, high saturated fatty acid (SFA) and high PUFA, in a crossover design to test whether a decrease in HDL can affect reverse cholesterol transport from relabeled macrophages. A significant decrease of LDL-C (in mmol/l) after a PUFA diet compared with an SFA diet from 3.15 6 0.65 to 2.80 6 0.56 (P , 0.01) was accompanied by a significant decrease of HDL cholesterol (HDL-C) (in mmol/l) from 1.21 6 0.30 to 1.10 6 0.32 (P , 0.05). These changes did not affect cholesterol efflux (CHE) from macrophages (9.74 6 1.46% vs. 9.53 6 1.41%). There was no correlation between individual changes of HDL-C and changes of CHE. It is concluded that the decrease of HDL-C after successful dietary intervention of LDL-C is not accompanied by a decrease of CHE.-Kralova Lesna, I., P. Coronary heart disease (CHD) due to atherosclerosis of the coronary arteries is the main cause of mortality in the Western world (1). One of the typical phenotypes associated with increased risk of CHD includes increased LDL cholesterol (LDL-C) and reduced concentrations of HDL. Several epidemiological and physiological data indicate that a change in lifestyle (diet, physical training) can significantly improve lipoprotein profile and prognosis of CHD (2, 3). Meta-analysis of 60 controlled trials (4), focused on the effects of dietary FAs, clearly demonstrated a significant decrease in LDL concentration when saturated fatty acids (SFAs) in a diet were replaced with unsaturated FAs, and this decrease was accompanied by a significant decrease in HDL concentration. It is not clear whether such a decrease of HDL cholesterol (HDL-C) concentration compromises the otherwise atheroprotective effect of such a diet change.The importance of low concentrations of HDL as risk factor for cardiovascular diseases was initially demonstrated in Miller et al. (5), and this finding has been repeatedly confirmed (6, 7).HDL represents a large family of particles differing in size, shape, and composition. Among several protective actions of HDL [protection of endothelial function, and anti-oxidative, anti-inflamatory, and anti-aggregative effects (8-10)], the capacity of HDL to accept cellular lipids and reverse cholesterol transport (RCT) are thought to be the most important. RCT is the key pathway for efflux of cholesterol molecules to extracellular acceptors and their transport to the liver to be metabolized to bile acids. Despite the fact that RCT from macrophages contributes only a little to the whole centripetal transport of cholesterol, this pathway is crucial (11), inasmuch as accumulation of esterified cholesterol in these cells is one of the first features of atherosclerosis.RCT is a complex process involving several steps. First, unesterified cholesterol is carried out to the plasma membrane and then is taken up int...

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Cardiovascular risk reductions associated with aggressive lifestyle modification and cardiac rehabilitation

Cited by 109 publications

References 20 publications

The Effect of Biofeedback on Function in Patients with Heart Failure

The Effect of Biofeedback on Function in Patients with Heart Failure

Determinants of quality of life five years after coronary artery bypass graft surgery

Replacement of dietary saturated FAs by PUFAs in diet and reverse cholesterol transport

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