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The Influence of Cardiac Rehabilitation on Inflammation and Metabolic Syndrome in Women With Coronary Heart Disease

Beckie, Theresa M. PhD; Beckstead, Jason W. PhD; Groer, Maureen W. PhD

The Journal of Cardiovascular Nursing: January-February 2010 - Volume 25 - Issue 1 - p 52-60
doi: 10.1097/JCN.0b013e3181b7e500
ARTICLES: Metabolic Syndrome
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Background: Metabolic syndrome (MetS) and increased inflammatory markers, both predictors of future cardiovascular events, are more prevalent in women with coronary heart disease (CHD). The influence of cardiac rehabilitation (CR) on MetS and inflammatory biomarkers is not well characterized for women.

Purpose: The purpose of this article was to examine the effects of a 12-week behaviorally enhanced CR exclusively for women compared with traditional CR on components of the MetS and inflammatory markers in women with CHD.

Methods: The randomized clinical trial used 2 treatment groups, both receiving a comprehensive 12-week CR program, with 1 group receiving a motivationally enhanced intervention exclusively for women. A subset of 91 women (mean age, 61.6 years) from the parent study provided serum samples to examine the effects of CR on high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1).

Results: After CR, the total sample of women demonstrated significant reductions in hsCRP (P =.002), IL-6 (P <.001), TNF-α (P =.010), and ICAM-1 (P =.016). Women in the gender-tailored CR program significantly improved all biomarker levels compared with baseline (P <.05 for all), whereas those in the traditional group improved only hsCRP (P <.05) and IL-6 (P <.05) levels. The combined study group demonstrated improvements in several components of MetS (triglycerides, waist circumference, and systolic blood pressure) but not in others (high-density lipoprotein cholesterol, fasting glucose, and diastolic blood pressure).

Conclusion: Cardiac rehabilitation promotes greater improvements in inflammatory biomarkers than in components of MetS for women with CHD. Improvements in body composition or weight may not be a precondition for the benefits of exercise because of loss of abdominal fat. Examining components of MetS as continuous variables is recommended to prevent lost information inherent in dichotomization.

Theresa M. Beckie, PhD Professor, College of Nursing, University of South Florida, Tampa.

Jason W. Beckstead, PhD Professor, College of Nursing, University of South Florida, Tampa.

Maureen W. Groer, PhD Professor, College of Nursing, University of South Florida, Tampa.

This study was sponsored through the following grants from the National Institutes of Health: R01 NR007678 and R01 NR007678-04S1.

Corresponding author Theresa M. Beckie, PhD, College of Nursing, University of South Florida, MDC Box 22, 12901 Bruce B. Downs Blvd, Tampa, FL 33612-4766 (tbeckie@health.usf.edu).

© 2010 Lippincott Williams & Wilkins, Inc.