Changes in plasma lipoproteins after cardiac rehabilitation in patients not on lipid-lowering drugs

Abstract

The extent to which a conventional cardiac rehabilitation programme can influence plasma lipoproteins was investigated in a prospective study. The relationship between changes in plasma lipoproteins and baseline characteristics, as well as variables related to the physical training and to dietary habits were assessed in 77 cardiac patients. All patients participated in a physical training programme, including general dietary advice. Patients who received lipid-lowering drugs were excluded from this study. Total plasma cholesterol decreased from 7.1 +/- 1.6 to 6.8 +/- 1.2 mmol l-1 (P less than 0.05), but it remained high in many patients, 61% having a level above 6.5 mmol l-1. The high- and low-density lipoprotein fractions (HDL- and LDL-cholesterol), and the ratio of total cholesterol to HDL-cholesterol, did not change significantly. The change in total plasma cholesterol was greatest (P less than 0.05) in patients who changed their diet in the recommended direction, and was poorly related to the change in maximal workload. It is concluded that a combination of general dietary advice and moderate physical exercise training is followed by a small reduction in total plasma cholesterol levels without changing HDL-cholesterol, and that cardiac rehabilitation should include strict programmes for the reduction of elevated plasma cholesterol.

Changes in lipid profile of patients referred to a cardiac rehabilitation program

“…This evaluation seems much more crucial in Iran. In a prospective study in which patients who received lipidlowering drugs were excluded, The HDL and LDL fractions did not change significantly after completion of a CRP including a combination of general dietary advice and moderate physical exercise training [16], whereas others have reported that CRP can improve LDL, HDL, and TG in patients with CVD [15]. It has also been reported that, based on the Rose Q and/or ECG, the prevalence of CVD was significantly higher among Iranian women than Iranian men [27].…”

“…It has also been reported that, based on the Rose Q and/or ECG, the prevalence of CVD was significantly higher among Iranian women than Iranian men [27]. In a prospective study in which patients who received lipid-lowering drugs were excluded, The HDL and LDL fractions did not change significantly after completion of a CRP including a combination of general dietary advice and moderate physical exercise training [16], whereas others have reported that CRP can improve LDL, HDL, and TG in patients with CVD [15]. In other investigations, the increases in HDL after completion of CRP have been demonstrated to be similar to those associated with drug therapy [28].…”

“…Cardiac rehabilitation programs (CRPs), first developed in the 1960s [7, 8], have been shown to have beneficial effects on mortality, exercise tolerance, functional capacity, lipid levels, blood pressure, symptoms of angina and dyspnea, weight loss, smoking behavior, stress level, and psychosocial functioning [9–12]. However, there are some controversies over the effect of CRP on different types of serum lipids [13–16], and racial differences have been mentioned in the degree of improvement of patients' lipid profile after CRP [17]. Considering the selective effect of lipid-lowering drugs on different types of serum lipids and the importance of lipid lowering in the management of patients with cardiovascular diseases, it seems vital to clarify the exact effect of CRP on different types of serum lipids for better selection of these drugs for patients completing a CRP.…”

The real role of exercise versus medication in lipid profile of patients referred to a cardiac rehabilitation program

“…2,6,7 There is controversy among findings of different studies. In a prospective study in which patients who received lipid-lowering drugs were excluded, the HDL and low-density lipoprotein (LDL) fractions did not change significantly after the completion of a CRP including a combination of general dietary advice and moderate physical exercise training, 8 whereas others have reported that CRP can improve LDL, HDL, and triglyceride (TG) in patients with cardiovascular disease. 9 In other investigations, the increases in HDL levels after completion of CRP have been shown to be similar to those associated with drug therapy.…”

Η Επίδραση Της Συστηματικής Άσκησης Σε Ασθενείς Με Στεφανιαία Νόσο

“…Από την άλλη μεριά βελτιώνοντας ο στεφανιαίος ασθενής το λιπιδαιμικό του προφίλ (μέσω φαρμακευτικής-διαιτητικής αγωγής ή άσκησης) μπορεί να επιβραδύνει ή ακόμη και να αναστείλει την εξέλιξη της αθηρωματικής βλάβης και να μειώσει την πιθανότητα για εμφάνιση μελλοντικών καρδιακών συμβαμάτων (Arntzenious et al 1985, Schuler et al 1988, Ornish et al 1990. Έχει επανειλημμένα αποδειχτεί ότι συστηματική αερόβια άσκηση μπορεί να επηρεάσει θετικά το προφίλ λιπιδίων τόσο σε άτομα με προδιάθεση για εμφάνιση ΣΝ (Berg et al 1994a) καθώς επίσης και σε ασθενείς με εκδήλωση ΣΝ (Härtung et al 1981, Tran & Brammel 1989, Baardman et al 1991, Warner et al 1995, Βόλακλης και συν. 1999.…”