Effects of Cardiac Rehabilitation in Diabetic Patients: Both Cardiac and Noncardiac Factors Determine Improvement in Exercise Capacity

Abstract BackgroundDiabetic patients have a worse prognosis than nondiabetic patients after myocardial infarction. Although exercise improves risk factors, exercise capacity, and mortality, it is still unclear if these benefits are the same as in nondiabetics. Furthermore, although exercise tolerance is predicted by systolic and diastolic dysfunction in nondiabetics, its role as a predictor of exercise capacity in diabetics remains unclear. HypothesisDiabetics and nondiabetics see a similar improvement in their cardiac risk factors and exercise parameters from exercise‐based cardiac rehabilitation (CR). MethodsA series of 370 diabetics and 942 nondiabetics entered a 36‐session outpatient CR program after interventions for coronary heart disease or after bypass or cardiac valve surgery. The program consisted of physical exercise, lifestyle modification, and pharmacotherapy. ResultsQuality of life, weight, blood pressure, and lipid profiles improved significantly in both groups during the 12‐week program. Baseline metabolic equivalents (METs) were lower in diabetics vs nondiabetics at the start of CR (2.4 vs 2.7, P
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: Clinical Investigation Source Type: research

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A risk-based prevention strategy is the most widely accepted approach to guide clinician-patient decision-making for prevention of coronary artery disease (CAD). According to this approach, the intensity of prevention efforts is matched to the estimated risk of the individual. American College of Cardiology/American Heart Association guidelines currently recommend pooled cohort equations for initial risk assessment, which integrate age, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking status, and treatment for hypertension and diabetes to provide race- and sex-specific estimates of ...
Source: JAMA - Category: General Medicine Source Type: research
In this study, we assessed the association between Twitter-derived sentiments towards racial/ethnic minorities at state-level and individual-level CVD-related outcomes from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). Outcomes included hypertension, diabetes, obesity, stroke, myocardial infarction (MI), coronary heart disease (CHD), and any CVD from BRFSS 2017 (N = 433,434 to 433,680 across outcomes). A total of 30 million race-related tweets were collected using Twitter Streaming Application Programming Interface (API) from 2015 to 2018. Prevalence of negative and positive sentiment towards r...
Source: Journal of Racial and Ethnic Health Disparities - Category: International Medicine & Public Health Source Type: research
For nearly two decades, the American Heart Association (AHA) has recommended that people with coronary heart disease (CHD) consume omega-3-fatty acids (the kinds of fatty acids found in fish and fish oil) to prevent another heart attack. This recommendation was based on early randomized, controlled trials, which found that fish oil supplementation was associated with lower rates of stroke, heart attack, and death in people who already had heart disease. On the other hand, the impact of fish oil supplements on preventing a first heart attack or stroke (primary prevention) was never clearly demonstrated. Recently there have ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Drugs and Supplements Health Heart Health Nutrition Source Type: blogs
AbstractBackgroundPatients with NAFLD are considered at a high risk of cardiovascular events due to underlying metabolic risk factors. Currently, data related to the impact of NAFLD on cardiovascular risk in the general population are lacking.AimsThe aim of this study was to investigate the role of NAFLD on risk of myocardial infarction (MI), coronary heart disease (CHD), atrial fibrillation (AF), and stroke in primary care in Germany.MethodsThe study included patients diagnosed with NAFLD in primary care between 2010 and 2015. NAFLD cases (n = 22,048) were matched to a cohort without NAFLD (n =&thinsp...
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
AbstractPurpose of ReviewTo review randomized interventional clinical and imaging trials that support lower targeted atherogenic lipoprotein cholesterol goals in “extreme” and “very high” atherosclerotic cardiovascular disease (ASCVD) risk settings. Major atherosclerotic cardiovascular event (MACE) prevention among the highest risk patients with ASCVD requires aggressive management of global risks, including lowering of the fundamental atherogenic ap olipoprotein B-associated lipoprotein cholesterol particles [i.e., triglyceride-rich lipoprotein remnant cholesterol, low-density lipoprotein cholester...
Source: Current Diabetes Reports - Category: Endocrinology Source Type: research
Diabetes mellitus (DM) or pre-diabetes status is closely associated with features of vulnerable coronary lesions in patients with stable coronary heart disease or acute coronary syndrome. However, the associat...
Source: Cardiovascular Diabetology - Category: Cardiology Authors: Tags: Original investigation Source Type: research
Conclusion: Low- or very-low-certainty evidence suggests that dietary patterns with less red and processed meat intake may result in very small reductions in adverse cardiometabolic and cancer outcomes. Primary Funding Source: None. (PROSPERO: CRD42017074074). PMID: 31569217 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
Conclusions: Hostility was associated with incidence of CHD among postmenopausal women with diabetes, especially among incident diabetes. These results provide a basis for targeted prevention programs for women with a high level of hostility and diabetes.
Source: Menopause - Category: OBGYN Tags: Original Articles Source Type: research
AbstractThe purpose of this study was to assess gender identity differences in CVD risk and CVD conditions among adults in the U.S. Using data from the 2014 –2017 BRFSS we compared CVD risk and CVD conditions in gender minorities (transgender men, transgender women and gender nonconforming persons) to both cisgender men and women. The sample consisted of 662,903 participants. Transgender women (AOR 1.34, 95% CI 1.05–1.72) and transgender men (AOR 1. 54, 95% CI 1.07–2.24) were more likely to be overweight than cisgender women. Compared to cisgender women, transgender women reported higher rates of diabetes...
Source: Journal of Behavioral Medicine - Category: Psychiatry Source Type: research
In this study, researchers studied 438,952 participants in the UK Biobank, who had a total of 24,980 major coronary events - defined as the first occurrence of non-fatal heart attack, ischaemic stroke, or death due to coronary heart disease. They used an approach called Mendelian randomisation, which uses naturally occurring genetic differences to randomly divide the participants into groups, mimicking the effects of running a clinical trial. People with genes associated with lower blood pressure, lower LDL cholesterol, and a combination of both were put into different groups, and compared against those without thes...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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