Abstract
Impairment in arterial compliance is associated with diabetes. Arterial stiffness is related to the cardiovascular disease risk. Treatments allowing arterial compliance increase should be relevant to improve prognosis. Previous studies have demonstrated that rehabilitation programs were able to improve arterial compliance in cardiac patients. In the present study, we have assessed the effect of a 6-week rehabilitation program on arterial compliance in diabetic patients (DP) in comparison with non-diabetic patients (NDP) with heart disease. 134 type2 DP and 160 NDP engaged in aerobic training and multidisciplinary educational interventions five days per week. DP and NDP were matched appropriately for age (respectively 57.5 vs 56.5 years), sex ratio (29% vs 25% women) and type of heart disease. Sixty one percent of DP was treated by insulin. Baseline HbA (1c) was greater than 6.6% in 64% of cases. Retinopathy and microalbuminuria were detected in respectively 31% and 36% of subjects. Large (C1) and small artery (C2) elasticity indices were measured using the HDI/PulseWaveTM CR-2000 Research CardioVascular Profiling System (Hypertension Diagnostics TM, Inc) before and after rehabilitation. Before exercise training C2 was lower in DP in comparison with NDP (3.3 vs 3.6 - p<0.02) whereas C1 was similar (15.7 vs 15.3 - p=0.6). After training, significant increases in C1 and C2 were found in the two groups. In diabetic patient a +9% increase in C1 (16.6 - p=0.01) and a 21% increase in C2 (4.2 - p<0.001) were found. This increase was assessed to +7% for C1 (16.7 - p=0.002) and to +18% for C2 (4.3 - p<0.001) in NDP. The percentage of increase in C1 and C2 was not statistically significant between DP and NDP. Small artery elasticity is lower in diabetics compared with non diabetics. A 6-week aerobic training and multidisciplinary educational program improves both large and small artery elasticity in DP and NDP.
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