Abstract
Long-term maintenance of changes in cardiovascular risk factors and physical capacity once patients leave the supervised program environment have not previously been reported. This study investigated the changes in physical capacity outcomes and cardiovascular risk factors in an Australian cardiac rehabilitation setting, and the maintenance of changes in these outcomes in the 12 months following cardiac rehabilitation attendance. Improvements in mean (95% CI) cardiorespiratory fitness (16.4% (13.2–19.6%), p < 0.001) and handgrip strength (8.0% (5.4–10.6%), p < 0.001) were observed over the course of the cardiac rehabilitation program, and these improvements were maintained in the 12 months following completion. Waist circumference (p = 0.003) and high-density lipoprotein cholesterol (p < 0.001) were the only traditional cardiovascular risk factors to improve during the cardiac rehabilitation program. Vigorous-intensity aerobic exercise was associated with significantly greater improvements in cardiorespiratory fitness, Framingham risk score, and waist circumference in comparison to moderate-intensity exercise. An increase in the intensity of the exercise prescribed during cardiac rehabilitation in Australia is recommended to induce larger improvements in physical capacity outcomes and cardiovascular risk. A standardized exercise test at the beginning of the rehabilitation program is recommended to facilitate appropriate prescription of exercise intensity.
Highlights
Cardiac rehabilitation is a recommended component of care for all people who have experienced an acute cardiac event
The Framingham Heart study risk score for recurrent coronary heart disease along with plasma HDL-C levels and waist circumference improved over the course of the cardiac rehabilitation program, but there were no changes to other traditional cardiovascular risk factors, including blood pressure, plasma lipids, and blood glucose levels, despite these not reaching optimal levels
This study investigated a small number of participants from a single cardiac rehabilitation program that was prescribed according to the Australian guidelines for cardiac rehabilitation [6], with only two females eligible for inclusion in the analyses
Summary
Cardiac rehabilitation is a recommended component of care for all people who have experienced an acute cardiac event This commonly includes supervised exercise training alongside nutritional and vocational counselling, psychosocial assessment and cardiovascular risk factor education [1]. Individuals attending cardiac rehabilitation typically have a lower cardiorespiratory fitness (CRF) and muscle strength compared with healthy age-matched individuals [2,3]. This is likely a consequence of structural and/or functional changes to the heart as a result of the acute cardiac event and subsequent medical treatment, alongside inactivityrelated declines following the restriction of activity levels due to hospitalisation and recovery [2]. Improvements in physical capacity through CRF and muscular strength assist
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