Metabolic syndrome (MetS) and elevated 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.
The purpose of this paper is to examine the effects of a 12-week behaviorally enhanced CR exclusively for women compared to traditional CR on components of the MetS and inflammatory markers in women with CHD.
The randomized clinical trial employed 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 alpha (TNF-α), and intercellular adhesion molecule-1 (ICAM-1).
Following 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 to baseline (P<.05 for all) while 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 the MetS (triglycerides, waist circumference, and systolic blood pressure) but not others (high-density lipoprotein cholesterol, fasting glucose, and diastolic blood pressure).
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 due to loss of abdominal fat. Examining components of MetS as continuous variables is recommended to prevent lost information inherent in dichotomization.