Document Detail

The treatment of obesity in cardiac rehabilitation.
MedLine Citation:
PMID:  20436355     Owner:  NLM     Status:  MEDLINE    
Obesity is an independent risk factor for the development of coronary heart disease (CHD). At entry into cardiac rehabilitation (CR), more than 80% of patients are overweight and more than 50% have the metabolic syndrome. Yet, CR programs do not generally include weight loss programs as a programmatic component and weight loss outcomes in CR have been abysmal. A recently published study outlines a template for weight reduction based on a combination of behavioral weight loss counseling and an approach to exercise that maximized exercise-related caloric expenditure. This approach to exercise optimally includes walking as the primary exercise modality and eventually requires almost daily longer-distance exercise to maximize caloric expenditure. In addition, lifestyle activities such as stair climbing and avoidance of energy-saving devices should be incorporated into the daily routine. Risk factor benefits of weight loss and exercise training in overweight CHD patients are broad and compelling. Improvements in insulin resistance, lipid profiles, blood pressure, clotting abnormalities, endothelial-dependent vasodilatory capacity, and measures of inflammation such as C-reactive protein have all been demonstrated. Cardiac rehabilitation/secondary prevention programs can no longer ignore the challenge of obesity management in CHD patients. Individual programs need to develop clinically effective and culturally sensitive approaches to weight control. Finally, multicenter randomized clinical trials of weight loss in CHD patients with assessment of long-term clinical outcomes need to be performed.
Philip A Ades; Patrick D Savage; Jean Harvey-Berino
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation and prevention     Volume:  30     ISSN:  1932-751X     ISO Abbreviation:  J Cardiopulm Rehabil Prev     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-09-02     Completed Date:  2011-06-02     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101291247     Medline TA:  J Cardiopulm Rehabil Prev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  289-98     Citation Subset:  IM    
University of Vermont College of Medicine, Burlington, 05482, USA.
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MeSH Terms
Behavior Therapy
C-Reactive Protein
Coronary Artery Disease / psychology,  rehabilitation*
Directive Counseling
Energy Metabolism
Exercise Therapy
Life Style
Obesity / psychology,  therapy*
Risk Factors
Treatment Outcome
Weight Loss
Grant Support
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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