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Attenuated Progression of Coronary Artery Disease After 6 Years of Multifactorial Risk Intervention: Role of Physical Exercise
Abstract
Background It was the aim of this study to assess the long-term effects of physical exercise and low-fat diet on the progression of coronary artery disease. At the beginning of the study, 113 male patients with coronary artery disease were randomized to an intervention group (n=56) or a control group (n=57); 90 patients (80%) could be reevaluated after 6 years. Methods and Results Patients in the intervention group (n=40) showed a reduction in total serum cholesterol (6.03±1.03 versus 5.67±1.01 mmol/L; P <.03) and triglyceride levels (1.94±0.8 versus 1.6±0.89 mmol/L; P <.005) and maintained their initial body mass index (26±2 versus 27±2 kg/m 2 ; P =NS), but results were not statistically different from the control group (n=50) (total serum cholesterol, 6.05±1.02 versus 5.79±0.88 mmol/L; triglycerides, 2.25±1.28 versus 1.85±0.96 mmol/L [both P =NS]; body mass index, 26±2 versus 28±3 kg/m 2 [ P <.0001]). In the intervention group, there was a significant 28% increase in physical work capacity (166±59 versus 212±89 W; P <.001), whereas values remained essentially unchanged in the control group (165±51 versus 170±60 W; P =NS; between groups, P <.05). In the intervention group, coronary stenoses progressed at a significantly slower rate than in the control group ( P <.0001). Energy expenditure during exercise was assessed in a subgroup; patients with regression of coronary stenoses spent an average of 1784±384 kcal/wk (≈4 hours of moderate aerobic exercise per week). Multivariate regression analysis identified only physical work capacity as independently contributing to angiographic changes. Conclusions After 6 years of multifactorial risk intervention, there is significant and persistent improvement in lipoprotein levels and physical work capacity, which results in a significant retardation of disease progression. These beneficial effects appear to be largely due to chronic physical exercise.
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“Some subsequent reports also demonstrated an increase in the RPP at the onset of angina as well as a reduction in the ischemic response measured as angina, ST-segment depression, 29 or nuclear and positron-emission tomography scanning perfusion defects 30,31 at a given RPP, which suggests that exercise training improved myocardial oxygen delivery.”
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Metadata
- Authors
- Niebauer, J., Hambrecht, R., Velich, T., Hauer, K., Marburger, C., Kälberer, B., Weiss, C., von Hodenberg, E., Schlierf, G., Schuler, G., Zimmermann, R., & Kübler, W.
- Affiliations
- Heidelberg University (DE)
- From Medizinische Universitätsklinik Heidelberg, Abteilung Innere Medizin III–Kardiologie (J.N., T.V., K.H., C.M., B.K., C.W., G. Schlierf, R.Z., W.K.), Heidelberg, Germany; Herzzentrum der Universität Leipzig (R.H., G. Schuler), Abteilung Innere Medizin–Kardiologie, Leipzig, Germany; and Herzzentrum Lahr (E. von H.), Abteilung Kardiologie, Lahr, Germany.
- Venue
- Circulation
- Published
- 1997-10-21
- Volume
- 96
- Issue
- 8
- Pages
- 2534-2541
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2085122671
- Cited by
- 372
- References
- 43
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 7 · 2019: 5 · 2018: 8 · 2017: 7 · 2016: 14 · 2015: 13 · 2014: 13 · 2013: 12 · 2012: 18
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- coronary artery disease, physical activity, low-fat diet, coronary stenosis progression, physical work capacity, serum cholesterol, triglycerides, body mass index, energy expenditure, male patients, lipoproteins, aerobic exercise, energy balance, smoking cessation, alcohol consumption reduction, blood pressure reduction, lipid lowering
- MeSH terms
- Adult, Aged, Cholesterol, Coronary Disease, Dietary Fats, Energy Metabolism, Cardiac Catheterization, Hemodynamics, Humans, Male, Middle Aged, Nicotine, Risk Factors, Smoking, Triglycerides, Exercise, Body Mass Index, Coronary Angiography
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