Weight Loss And Fitness In Patients With Coronary Artery Disease Through Cardiac Rehabilitation – A Long Term Follow-Up.

Abstract

Background and rationale: excess body weight is an established cardiovascular risk factor. Current literature on the effects of cardiac rehabilitation (CR) in weight reduction has been inconclusive and none has provided results for an ongoing long term supervised exercise program beyond 3 months. We therefore undertake to determine the relationship of CR with ongoing supervised exercise program for over two years on weight reduction and fitness. Method: This is an observational study of 47 CR patients who were followed up for ≥24 months. Patients were assessed at their entry and exit of Phase II CR and at 12 and 24 months of Phase III programs. Results: No significant weight change occurred during either phase of CR for all pre-defined weight ranges in either Phase II or Phase III while exercise capacity increased by 3.3±1.1 METs (P<0.0001) and 0.6±1.24 METs, (p=0.1) respectively. Conclusion: The study demonstrates that CR even in a long-term setting does not significantly reduce weight amongst participants. To reduce excess weight as a risk factor, further interventions such as more exercise sessions or longer, more strenuous sessions, or dietary interventions should be considered. Condensed Abstract: We conducted a retrospective observational study into the affect of long term CR on weight loss and fitness levels. No weight loss was observed after a 2 years exercise program, while fitness levels improved markedly and were maintained over the study duration. BACKGROUND AND RATIONALE Cardiac rehabilitation (CR) following a cardiac event has been shown to reduce risk of mortality by 25% over three years. While CR was originally centered around exercise and improving physical function, the current guidelines recommend that assessment and targeting of risk factors should be an integral part of CR. Obesity is an established cardiovascular risk factor (CRF), and even patients who are overweight (BMI 25-29.9) are shown to be at an increased risk of cardiovascular events. The majority of CR patients are overweight or obese, and over half of CR patients are thought to have metabolic syndrome. Therefore, weight reduction and maintenance in an ideal weight range would seem a natural and prognostically relevant objective of CR. Recent literature on the effects of CR in weight reduction has been inconclusive. While a few studies showed CR resulted in body weight reduction, others have not been able to demonstrate this. None has provided ongoing long term supervised exercise program beyond 3 months. Peak exercise capacity has been found to be the strongest predictor of mortality in men with cardiovascular disease. While CR has been shown to markedly improve exercise capacity for patients of all weight ranges, the maintenance of fitness with long term CR is yet to be established. We therefore undertake to determine the relationship of CR including an ongoing exercise program for over two years on weight reduction and fitness.