Is it possible that a cardiac rehabilitation program can reduce the cardiovascular risk in individuals with metabolic syndrome?
DOI:
https://doi.org/10.33233/rbfex.v20i4.4541Keywords:
metabolic syndrome; diabetes; cardiac rehabilitation; lifestyleAbstract
Background: Metabolic syndrome is a complex disorder represented by a set of cardiovascular risk factors usually related to central fat deposition, insulin resistance, hypertension, and dyslipidemia. It is associated with accelerated atherosclerosis in response to chronic inflammation and vascular endothelial dysfunction, increasing overall mortality. Objective: We aimed to evaluate the effect of a cardiac rehabilitation program on cardiovascular risk factors in patients with metabolic syndrome. Methods: This is prospective interventional study. All patients underwent a 20-session cardiac rehabilitation program with aerobic and resisted exercises as well as an educational program for lifestyle changes. Results: Forty-seven patients participated in the present study. After the cardiac rehabilitation program (CRP), a significant reduction (p = 0,0092) for cardiovascular risk and fatigue (p > 0.001) was observed; 78% of the patients had positive effects on physical capacity, 72% of the patients presented HbA1c reduction, 51% increased HDL-cholesterol, 70% reduced total cholesterol, 63% reduced triglycerides, 61% reduced systolic blood pressure and 53% reduced diastolic blood pressure. Conclusion: Cardiac rehabilitation program with aerobic and resisted exercises associated with educational program for lifestyle changes is an effective approach in the treatment of patients with metabolic syndrome mainly seen by a reduced cardiovascular risk factors and reducing fatigue, improved physical capacity and reduced components of metabolic syndrome.
References
Kuschnir MCC, Bloch KV, Szklo M, Klein CH, Barufaldi LA, Abreu GDA, Moraes AJ PD. ERICA: prevalence of metabolic syndrome in Brazilian adolescents. Rev Saúde Pública 2016;50(11):256-68. doi: 10.1590/S01518-8787.2016050006701
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287(3):356-9. doi: 10.1001/jama.287.3.356
Tjønna AE, Lee SJ, Rognmo Ø, Stølen TO, Bye A, Haram PM, et al. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome. Circulation 2008;118(4):346-54. doi: 10.1161/CIRCULATIONAHA.108.772822
Porto EF, Souza AC. Health promotion and lifestyle: limitations and perspectives. Lifesytle Journal 2016;4(2):7-9. doi: 10.19141/2237-3756.lifestyle.v3.n2.p7-10
Takahara M, Shimomura I. Metabolic syndrome and lifestyle modification. Rev Endocr Metab Dis 2014;15(4):317-27. doi: 10.1007/s11154-014-9294-8
Lavie CJ, Milani RV. Cardiac rehabilitation and exercise training programs in metabolic syndrome and diabetes. J Cardiopulm Rehabil 2005;25(2):59-66. doi: 10.1097/00008483-200503000-00001.
Savage PD, Banzer JA, Balady GJ, Ades PA. Prevalence of metabolic syndrome in cardiac rehabilitation/secondary prevention programs. American Heart Journal 2005;149(4):627-31. doi: 10.1016/j.ahj.2004.07.037
Lavie CJ, Morshedi?Meibodi A, Milani RV. Impact of cardiac rehabilitation on coronary risk factors, inflammation, and the metabolic syndrome in obese coronary patients. J Cardiometab Syndr 2008;3(3):136-40. doi: 10.1111/j.1559-4572.2008.00002.x
Galvão TF, Pereira MG. Systematic reviews of the literature: steps for preparation. Epidemiol Serv Saúde 2014;23(1):183-4. doi: 10.5123/S1679-49742014000100018
Santos CMDC, Pimenta, CADM, Nobre MRC. The PICO strategy for the research question construction and evidence search. Rev Latinoam Enferm 2007;15(3):508-511. doi: 10.1590/s0104-11692007000300023
World Medical Association (WMA). Declaration of Helsinki. [Internet]. 2013 [cited 2021 Jun 12]. Available from: http://www.wma.net/en/ 30publications/10policies/b3/
Castro JBP, Souza Vale RG, Aguiar RS, Silva Mattos R. Perfil do estilo de vida de universitários de Educação Física da cidade do Rio de Janeiro. Revista Brasileira de Ciência e Movimento 2017;25(2):73-83. doi: 10.18511/rbcm.v25i2.6234
Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright S, Wallace EP. Development of a fatigue scale. Journal of Psychosomatic Research 1993;37(2):147-53. doi: 10.1016/0022-3999(93)90081-P
Karvonen JJ, Kentala E, Mustalam O. The effects of training on heart rate: a “longitudinal” study. Ann Med Exp Biol Fenn 1957;35:307-15. doi: 10.1038/sj.jhh.1002173
Fung TT, Hu FB, Wu K, Chiuve SE, Fuchs CS, Giovannucci E. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and colorectal cancer. Am J Clin Nutr 2010;92(6):1429-35. doi: 10.3945/ajcn.2010.29242
Meira MDD, Abdala GA, Teixeira CA, Ninahuaman MFM, Moraes MCL. Profile of adult lifestyle of São Paulo south zone. Life Style Journal [Internet]. 2015 [cited 2021 Jun 12];2(2):29-45. https://revistas.unasp.edu.br/LifestyleJournal/article/view/607
World Health Organization (WHO). The top 10 causes of death. 2016 [cited 2018 April 15]. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/index3.html
Pontes HT, Araujo SP, CorrêA CD, Cerqueira PA, Oliveira NC, Portes LA. Supervised physical activity and metabolic syndrome components of women assisted in primary health care. J Metabolic Synd 2012;1(111):2167-0943. doi: 10.4172/2167-0943.1000111
Fletcher GF, Landolfo C, Niebauer J, Ozemek C, Arena R, Lavie CJ. Promoting physical activity and exercise: JACC health promotion series. J Am Coll Cardiol 2018;72(14):1622-39. doi: 10.1016/j.jacc.2018.08.2141
Ozemek C, Lavie CJ, & Rognmo Ø. Global physical activity levels-Need for intervention. Prog Cardiovasc Dis 2019;62(2):102-7. doi: 10.1016/j.pcad.2019.02.004
Lavie CJ, Ozemek C, Carbone S, Katzmarzyk PT, Blair SN. Sedentary behavior, exercise, and cardiovascular health. Circ Res 2019;124(5):799-815. doi: 10.1161/CIRCRESAHA.118.312669
Chagas EFB, Bonfim MR, Brondino NCM, Monteiro HL. Physical exercise and cardiovascular risk factors in obese women in the postmenopausal period. Rev Bras Med Esporte 2015;21(1):65-9. doi: 10.1590/1517-86922015210101834
Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, Lauer MS. Cardiac rehabilitation and secondary prevention of coronary heart disease. Circulation 2005;111:369-76. doi: 10.1161/01.CIR.0000151788.08740.5C
Porto EF, Kumpel C, Portes LA, Leite JRO. Comparative study between two methods of supervised and semi-supervised cardiac rehabilitation on maximal oxygen consumption and functional capacity. Rev Soc Cardiol Estado de São Paulo [Internet]. 2007 [cited 2021 Jun 12];17(2):18-24. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/lil-461835
Ciolac EG, Guimarães GV. Ejercicio físico y síndrome metabólico. Rev Bras Med Esporte 2004;10(4)319-24. doi: 10.1590/S1517-86922004000400009
Pozehl B, Ducan K, Hertzog M. The effects of exercise training on fatigue and dyspnea in heart failure. Eur J Cardiovasc Nurs 2008;7(2):127-132. doi: 10.1016/j.ejcnurse.2007.08.002
Jackson L, Leclerc J, Erskine Y, Linden W. Getting the most out of cardiac rehabilitation: a review of referral and adherence predictors. Heart 2005;91(1):10-14. doi: 10.1136/hrt.2004.045559
Mann DL, Reid MB. Exercise training and skeletal muscle inflammation in chronic heart failure: feeling better about fatigue. J Am Coll Cardiol 2003;42(5):869-72. doi: 10.1016/S0735-1097(03)00847-7
Windthorst P, Mazurak N, Kuske M, Hipp A, Giel KE, Enck P, Nieb A, Zipfel S, Teufel M. Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome: An exploratory pilot study. J Psychosom Res 2017;93:6-13. doi: 10.1016/j.jpsychores.2016.11.014
Pattyn N, Cornelissen VA, Eshghi SRT, Vanhees L. The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome. Sports Med 2013;43(2):121-33. doi: 10.1007/s40279-012-0003-z
Chagas EFB, Bonfim MR, Brondino NCM, Monteiro HL. Physical exercise and cardiovascular risk factors in obese women in the postmenopausal period. Rev Bras Med Esporte 2015;21(1):65-9. doi: 10.1590/1517-86922015210101834
Milani RV, Lavie CJ. Prevalence and profile of metabolic syndrome in patients following acute coronary events and effects of therapeutic lifestyle change with cardiac rehabilitation. Am J Cardiol 2003;92(1):50-4. doi: 10.1016/s0002-9149(03)00464-8.
Lavie CJ, Milani RV, O'Keefe JH. Dyslipidemia intervention in metabolic syndrome: emphasis on improving lipids and clinical event reduction. Am J Med Sci 2011;341(5):388-93. doi: 10.1097/MAJ.0b013e31821483fa
Rubenfire M, Mollo L, Krishnan S, Finkel S, Weintraub M, Gracik T, Kohn D, Oral EA. The metabolic fitness program lifestyle modification for the metabolic syndrome using the resources of cardiac rehabilitation. J Cardiopulm Rehabil Prev 2011;31:282-9. doi: 10.1097/HCR.0b013e318220a7eb
Rodriguez-Escudero JP, Somers VK, Heath AL, Thomas RJ, Squires RW, Sochor O, Lopez-Jimenez F. Effect of a lifestyle therapy program using cardiac rehabilitation resources on metabolic syndrome components. J Cardiopulm Rehabil Prev 2013;33(6):360-70. doi: 10.1097/HCR.0b013e3182a52762
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Copyright (c) 2021 Ana Denise Brandão, Keila Larissa Pereira Reis, Nathalia Moraes Ribeiro, Patricia Figueiredo, Daniela Martins de Fausto, Antônio Adolfo Mattos de Castro, Elias Ferreira Porto
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