January 27, 2015
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Leisure-time physical activity reduced CV risk in CAD patients with and without diabetes

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In patients with coronary artery disease, whether they had type 2 diabetes or not, routine leisure-time physical activity was inversely associated with short-term cardiovascular morbidity and mortality, according to research published in Diabetes Care.

“Patients with no or reduced levels of leisure-time physical activity had an over twofold increased risk of a composite cardiovascular endpoint compared with those who engaged in leisure-time physical activity over three times weekly,” the researchers wrote.

However, patients with CAD, both with or without diabetes, showed only modest improvements in CV risk profile during 2 years with controlled home-based exercise training.

Jaana J. Karjalainen, MSc, of the department of exercise and medical physiology, Verve Research, Oulu, Finland, and colleagues studied the effects of leisure-time physical activity (LTPA; n=539 with diabetes; n=507 without) and 2-year controlled home-based exercise training (n=63 with diabetes plus n=64 controls with diabetes; n=72 without plus 68 controls without) on CV risk profile and composite endpoint among patients with CAD.

The research was a substudy of the Innovation to Reduce Cardiovascular Complications of Diabetes at the Intersection (ARTEMIS) study.

The investigators assessed LTPA, based on categories of intensity and frequency, through health questionnaires completed by patients at baseline. Exercise training, composed of endurance and strength-based activity, was measured through diaries.

At 2 years, patients with reduced LTPA were at higher risk for CV events than those with LTPA more than three times weekly. The adjusted HR was 2.3 for no LTPA (95% CI, 1.1–5.1), 2.1 for irregular LTPA (95% CI, 1.1–4.2) and 2 for LTPA two to three times per week (95% CI, 1–3.9).  

Exercise training led to positive changes in exercise capacity in patients with type 2 diabetes (+0.2 ± 0.8 vs. –0.1 ± 0.8 metabolic equivalents of task [MET]; P=.03) and without (+0.3 ± 0.7 vs. –0.1 ± 0.5 MET; P=.002) compared with controls. No significant effects were seen for major metabolic or autonomic nervous system risk factors in patients with CAD with or without diabetes.

“These findings highlight the significance of lifelong physical activity instead of a short-term exercise program in the prevention of future unfavorable outcomes in patients with coronary artery disease,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.