Abstract

Background: Improvement in cardiorespiratory fitness during comprehensive cardiac rehabilitation (CR) is associated with improved cardiovascular prognosis. However, data on the improvement of intermediate outcomes (IOs) also associated with improved prognosis, i.e., low density lipoprotein (LDL) cholesterol and systolic blood pressure (SBP), in patients living with diabetes (DM) has been conflicting. The aim of this study is to characterize the integrated effects of combining strength and aerobic training on these IOs and functional capacity for patients living with and without DM. Methods: We retrospectively reviewed 377 CR program enrollments from 333 individual patients from 12/2019 - 3/2022. Paired functional capacity was assessed by the metabolic equivalent of task (METs) in a 6-minute walk test (6-MWT), arm curl reps, chair-to-stand reps, and timed up and go test. Demographics and IOs were obtained from the electronic records. P-values were determined by the Chi-square test for categorical variables and Mann-Whitney U test for continuous variables. Results: Baseline demographics and comorbidities of our cohort are described in Table 1. Patients with DM had more CAD and CKD. All patients undergoing CR showed integrated improvements in LDL with functional capacity in this paired analysis. However, patients without DM demonstrated a more significant reduction in SBP (Table 2). Conclusions: Combining strength and aerobic training resulted in integrated improvements in lipids and functional outcomes between patients with and without DM. Our results highlight the efficacy of this combined training for all CR patients, and the need for closer monitoring and management of SBP, a critical disease driver in patients with DM, CAD, and CKD.

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