Exercise-based cardiac rehabilitation in patients with coronary heart disease: meta-ana-lysis outcomes revisited

被引:97
作者
Oldridge, Neil [1 ]
机构
[1] Univ Wisconsin, Sch Med & Publ Hlth, Aurora Cardiovasc Serv, Aurora Med Grp, 6975 N Elm Tree Rd, Milwaukee, CO 53217 USA
关键词
cardiac rehabilitation; coronary heart disease; cost-effectiveness; exercise training; hospital admissions; meta-ana-lysis; mortality; outcomes; reinfarction; risk factor management;
D O I
10.2217/FCA.12.34
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiac rehabilitation that includes either exercise training alone or exercise training in addition to psychosocial, risk factor management and/or educational interventions is considered a Class I indication [i.e., useful and effective] for patients with coronary heart disease. This overview of six independent cardiac rehabilitation meta- analyses published since 2000 includes a total of 71 randomized clinical trials (n = 13,824 patients) and clearly demonstrates significant clinical outcomes (reduced all- cause and cardiac mortality, nonfatal reinfarction and reduced hospitalization rates) and significant positive changes in modifiable risk factors (total cholesterol, triglycerides and systolic blood pressure). Despite the observation that the elderly, females, minority ethnic groups, low socioeconomic status patients and patients with comorbidities have not been well represented in the randomized clinical trials. Recent guidelines in the UK and USA have concluded with the recommendation that cardiac rehabilitation is reasonable and necessary and should be promoted by healthcare professionals, including senior medical staff.
引用
收藏
页码:729 / 751
页数:23
相关论文
共 114 条
[31]   Exercise based rehabilitation for heart failure [J].
Davies, Ed J. ;
Moxham, Tiffany ;
Rees, Karen ;
Singh, Sally ;
Coats, Andrew J. S. ;
Ebrahim, Shah ;
Lough, Fiona ;
Taylor, Rod S. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2010, (04)
[32]   Exercise training for systolic heart failure: Cochrane systematic review and meta-analysis [J].
Davies, Edward J. ;
Moxham, Tiffany ;
Rees, Karen ;
Singh, Sally ;
Coats, Andrew J. S. ;
Ebrahim, Shah ;
Lough, Fiona ;
Taylor, Rod S. .
EUROPEAN JOURNAL OF HEART FAILURE, 2010, 12 (07) :706-715
[33]   Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials [J].
Dickinson, HO ;
Mason, JM ;
Nicolson, DJ ;
Campbell, F ;
Beyer, FR ;
Cook, JV ;
Williams, B ;
Ford, GA .
JOURNAL OF HYPERTENSION, 2006, 24 (02) :215-233
[34]   Blood lipid and lipoprotein adaptations to exercise - A quantitative analysis [J].
Durstine, JL ;
Grandjean, PW ;
Davis, PG ;
Ferguson, MA ;
Alderson, NL ;
DuBose, KD .
SPORTS MEDICINE, 2001, 31 (15) :1033-1062
[35]   Exercise characteristics and the blood pressure response to dynamic physical training [J].
Fagard, RH .
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 2001, 33 (06) :S484-S492
[36]   Effect of exercise on blood pressure control in hypertensive patients [J].
Fagard, Robert H. ;
Cornelissen, Veronique A. .
EUROPEAN JOURNAL OF CARDIOVASCULAR PREVENTION & REHABILITATION, 2007, 14 (01) :12-17
[37]   2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: A report of the American college of cardiology/American heart association task force on practice guidelines writing group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina [J].
Fraker, Theodore D., Jr. ;
Fihn, Stephan D. ;
Gibbons, Raymond J. ;
Abrams, Jonathan ;
Chatterjee, Kanu ;
Daley, Jennifer ;
Deedwania, Prakash C. ;
Douglas, John S. ;
Ferguson, T. Bruce ;
Fihn, Stephan D. ;
Fraker, Theodore D. ;
Gardin, Julius M. ;
O'Rourke, Robert A. ;
Pasternak, Richard C. ;
Williams, Sankey V. .
CIRCULATION, 2007, 116 (23) :2762-2772
[38]   Obesity reduction and its possible consequences:: What can we learn from Cuba's Special Period? [J].
Franco, Manuel ;
Ordunez, Pedro ;
Caballero, Benjamin ;
Cooper, Richard S. .
CANADIAN MEDICAL ASSOCIATION JOURNAL, 2008, 178 (08) :1032-1034
[39]   Novel therapeutic concepts - The epidemic of cardiovascular disease in the developing world: global implications [J].
Gersh, Bernard J. ;
Sliwa, Karen ;
Mayosi, Bongani M. ;
Yusuf, Salim .
EUROPEAN HEART JOURNAL, 2010, 31 (06) :642-648B
[40]   Secondary prevention through cardiac rehabilitation -: Position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology [J].
Giannuzzi, P ;
Saner, H ;
Björnstad, H ;
Fioretti, P ;
Mendes, M ;
Cohen-Solal, A ;
Dugmore, L ;
Hambrecht, R ;
Hellemans, I ;
McGee, H ;
Perk, J ;
Vanhees, L ;
Veress, G .
EUROPEAN HEART JOURNAL, 2003, 24 (13) :1273-1278