Effects of Aerobic Exercises on Patients With Coronary Artery Disease

Document Type : Research Paper

Authors

1 Department of Exercise Physiology, Faculty of Sport Sciences, University Campus 2, University of Guilan, Rasht, Iran.

2 Department of Cardiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction: Prescribing the Adrenergic beta-Antagonists is very common in treating cardiovascular diseases. The aim of this study was to compare the effects of aerobic training in patients with coronary artery disease, prescribed two different types of beta-blockers (selective and non- selective) on the patient's lipid profile (Lipoproteins) and FBS (Blood Glucose).
Materials and Methods: Sixty patients with coronary artery disease, aged 45-65 years, were compared in two groups of selective (n=36) and non-selective (n=24) users of beta-blockers. The training program consisted of 8 weeks of aerobic exercise on the treadmill (3 sessions per week, about 50 minutes per session, with an intensity of 40% to 60% of the heart rate reserve). Each study patient’s lipid profile and FBS level were obtained before the onset of the study and after the end of the intervention. The collected data were analyzed using repeated-measures Analysis of Variance (ANOVA).
Results: In the selective group, lipid profile and FBS did not significantly change. In the non-selective group, FBS and triglyceride levels were significantly reduced after the intervention; however, HDL, LDL, and total cholesterol levels were not significantly changed (P>0.05).
Conclusion: The results of this study showed that aerobic training in patients with CAD who used non-selective beta-blockers has more positive effects.

Keywords


  1. Ades PA, Gunther PG, Meyer WL, Gibson TC, Maddalena J, Orfeo T. Cardiac and skeletal muscle adaptations to training in systemic hypertension and effect of beta blockade (metoprolol or propranolol). The American Journal of Cardiology. 1990; 66(5):591-6. [DOI:10.1016/0002-9149(90)90486-K][PMID]
  2. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey Jr DE, et al. 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2013; 61(23):e179-347. [DOI:10.1016/j.jacc.2013.01.014] [PMID]
  3. Balady GJ, Ades PA, Bittner VA, Franklin BA, Gordon NF, Thomas RJ, et al. Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical centers and beyond: A presidential advisory from the American Heart Association. Circulation. 2011; 124(25):2951-60. [DOI:10.1161/CIR.0b013e31823b21e2] [PMID]
  4. Bangalore S, Messerli FH. Beta-blockers as fourth-line therapy for hypertension: Stay the course. International Journal of Clinical Practice. 2008; 62(11):1643-6. [DOI:10.1111/j.1742-1241.2008.01916.x] [PMID]
  5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42(6):1206-52. [DOI:10.1161/01.HYP.0000107251.49515.c2] [PMID]
  6. Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: A meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010; 376(9753):1670-81. [DOI:10.1016/S0140-6736(10)61350-5]
  7. do Vale GT, Ceron CS, Gonzaga NA, Simplicio JA, Padovan JC. Three generations of β-blockers: History, class differences and clinical applicability. Current Hypertension Reviews. 2019; 15(1):22-31. [DOI:10.2174/1573402114666180918102735] [PMID]
  8. Foerster EC, Greminger P, Siegenthaler W, Vetter H, Vetter W. Comparison between atenolol and pindolol in essential hypertension. In: Schettler G, Assmann G, Diehm C, Moerchel J, editors. Betablocker und Lipidstoffwechsel. Heidelberg: Springer; 1984. [DOI:10.1007/978-3-642-69675-6_17]
  9. Fonseca VA. Effects of beta-blockers on glucose and lipid metabolism. Current Medical Research and Opinion. 2010; 26(3):615-29. [DOI:10.1185/03007990903533681] [PMID]
  10. Gibson AL, Wagner DR, Heyward VH. Advanced fitness assessment and exercise prescription. 8th ed. Champaign: Human Kinetics Press; 2018. https://books.google.com/books?id=FjxnDwAAQBAJ&dq
  11. Goff Jr DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 129(25 Suppl 2):S49-73. [DOI:10.1161/01.cir.0000437741.48606.98] [PMID]
  12. Hansen D, Dendale P, Berger J, Meeusen R. Rehabilitation in cardiac patients: What do we know about training modalities? Sports Medicine. 2005; 35(12):1063-84. [DOI:10.2165/00007256-200535120-00005] [PMID]
  13. Anderson L, Thompson DR, Oldridge N, Zwisler AD, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. The Cochrane Database of Systematic Reviews. 2016; 2016(1):CD001800. [DOI:10.1002/14651858.CD001800.pub3] [PMID] [PMCID]
  14. Kraus WE, Houmard JA, Duscha BD, Knetzger KJ, Wharton MB, McCartney JS, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. The New England Journal of Medicine. 2002; 347(19):1483-92. [DOI:10.1056/NEJMoa020194] [PMID]
  15. Ladage D, Schwinger RH, Brixius K. Cardio-selective beta-blocker: Pharmacological evidence and their influence on exercise capacity. Cardiovascular Therapeutics. 2013; 31(2):76-83. [DOI:10.1111/j.1755-5922.2011.00306.x] [PMID]
  16. LeMura LM, von Duvillard SP, Andreacci J, Klebez JM, Chelland SA, Russo J. Lipid and lipoprotein profiles, cardiovascular fitness, body composition, and diet during and after resistance, aerobic and combination training in young women. European Journal of Applied Physiology. 2000; 82(5-6):451-8. [DOI:10.1007/s004210000234] [PMID]
  17. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: A meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007; 370(9602):1829-39. [DOI:10.1016/S0140-6736(07)61778-4]
  18. American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. Philadelphia: Wolters Kluwer; 2018. https://books.google.com/books?id=m_L-jwEACAAJ&dq
  19. Nordestgaard BG, Wootton R, Lewis B. Selective retention of VLDL, ODL, and LDL in the arterial intima of genetically hyperlipidemic rabbits in vivo. Molecular size as a determinant of fractional loss from the intima-inner media. Arteriosclerosis, Thrombosis, and Vascular Biology. 1995; 15(4):534-42. [DOI:10.1161/01.ATV.15.4.534] [PMID]
  20. Nybo L, Sundstrup E, Jakobsen MD, Mohr M, Hornstrup T, Simonsen L, et al. High-intensity training versus traditional exercise interventions for promoting health. Medicine and Science in Sports and Exercise. 2010; 42(10):1951-8. [DOI:10.1249/MSS.0b013e3181d99203] [PMID]
  21. O’Donovan G, Owen A, Bird SR, Kearney EM, Nevill AM, Jones DW, et al. Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate- or high-intensity exercise of equal energy cost. Journal of Applied Physiology. 2005; 98(5):1619-25. [DOI:10.1152/japplphysiol.01310.2004] [PMID]
  22. Ong HT. Beta blockers in hypertension and cardiovascular disease. BMJ 2007; 334(7600):946-9. [DOI:10.1136/bmj.39185.440382.47] [PMID] [PMCID]
  23. Pedersen B, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scandinavian Journal of Medicine & Science in Sports. 2006; 16(Suppl 1):3-63. [DOI:10.1111/j.1600-0838.2006.00520.x] [PMID]
  24. American College of Sports Medicine. ACSM’s advanced exercise physiology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins Press; 2012. https://books.google.com/books?id=MHiicQAACAAJ&dq
  25. Sharma AM, Pischon T, Hardt S, Kunz I, Luft FC. Hypothesis: Beta-adrenergic receptor blockers and weight gain: A systematic analysis. Hypertension. 2001; 37(2):250-4. [DOI:10.1161/01.HYP.37.2.250] [PMID]
  26. Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K, et al. Exercise-based rehabilitation for patients with coronary heart disease: Systematic review and meta-analysis of randomized controlled trials. The American Journal of Medicine. 2004; 116(10):682-92. [DOI:10.1016/j.amjmed.2004.01.009] [PMID]
  27. World Health Organization (WHO). The top 10 causes of death [Internet]. 2020 [Updated 2020 December 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
  28. Torres N, Guevara-Cruz M, Velázquez-Villegas LA, Tovar AR. Nutrition and atherosclerosis. Archives of Medical Research. 2015; 46(5):408-26. [DOI:10.1016/j.arcmed.2015.05.010] [PMID]
  29. Toth PP, Barter PJ, Rosenson RS, Boden WE, Chapman MJ, Cuchel M, et al. High-density lipoproteins: A consensus statement from the National Lipid Association. Journal of Clinical Lipidology. 2013; 7(5):484-525. [DOI:10.1016/j.jacl.2013.08.001] [PMID]
  30. Varady KA, St-Pierre AC, Lamarche B, Jones PJ. Effect of plant sterols and endurance training on LDL particle size and distribution in previously sedentary hypercholesterolemic adults. European Journal of Clinical Nutrition. 2005; 59(4):518-25. [DOI:10.1038/sj.ejcn.1602106] [PMID]
  31. Weir MR, Moser M. Diuretics and beta-blockers: Is there a risk for dyslipidemia? American Heart Journal. 2000; 139(1 Pt 1):174-84. [DOI:10.1016/S0002-8703(00)90325-9]