Objective: To determine whether lipid profiles and recurrent coronary heart disease (CHD) risk could be modified in patients with and without diabetes mellitus undergoing long-term cardiac rehabilitation (CR). Design: Retrospective analysis of patient case records. Setting: Community-based phase 4 CR program. Participants: Patients without diabetes (n=154; 89% men; mean ± SD age, 59.6±8.5y; body mass index [BMI], 27.0±3.5kg/m2) and patients with diabetes (n=20; 81% men; mean age, 63.0±8.7y; BMI, 28.7±3.3kg/m2) who completed 15 months of CR. Interventions: Exercise testing and training, risk profiling, and risk-factor education. Main Outcome Measures: Cardiometabolic risk factors and 2- to 4-year Framingham recurrent CHD risk scores were assessed. Results: At follow up, a significant main effect for time was evident for decreased body mass and waist circumference and improved low-density lipoprotein cholesterol (LDL-C) level and submaximal cardiorespiratory fitness (all P<.05), showing the benefits of CR in both groups. However, a significant group-by-time interaction effect was evident for high-density lipoprotein cholesterol (HDL-C) level and total cholesterol (TC)/HDL-C ratio (both P<.05). TC/HDL-C ratio improved (5.0±1.5 to 4.4±1.3) in patients without diabetes, but showed no improvement in patients with diabetes (4.8±1.6 v 4.9±1.6). Conclusions: We showed that numerous anthropometric, submaximal fitness, and cardiometabolic risk variables (especially LDL-C level) improved significantly after long-term CR. However, some aspects of cardiometabolic risk (measures incorporating TC and HDL-C) improved significantly in only the nondiabetic group. © 2011 American Congress of Rehabilitation Medicine.
Carroll, S., Tsakirides, C., Hobkirk, J., Moxon, J. W. A., Moxon, J. W. D., Dudfield, M., & Ingle, L. (2011). Differential improvements in lipid profiles and framingham recurrent risk score in patients with and without diabetes mellitus undergoing long-term cardiac rehabilitation. Archives of Physical Medicine and Rehabilitation, 92(9), 1382–1387. https://doi.org/10.1016/j.apmr.2011.04.013