Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials

Taylor, Rod S., Brown, Allan, Ebrahim, Shah, Jolliffe, Judith, Noorani, Hussein, Rees, Karen, Skidmore, Becky, Stone, James A., Thompson, David R. and Oldridge, Neil (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. American Journal of Medicine, 116 10: 682-692. doi:10.1016/j.amjmed.2004.01.009


Author Taylor, Rod S.
Brown, Allan
Ebrahim, Shah
Jolliffe, Judith
Noorani, Hussein
Rees, Karen
Skidmore, Becky
Stone, James A.
Thompson, David R.
Oldridge, Neil
Title Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials
Journal name American Journal of Medicine   Check publisher's open access policy
ISSN 1555-7162
0002-9343
Publication date 2004-05-15
Sub-type Article (original research)
DOI 10.1016/j.amjmed.2004.01.009
Open Access Status
Volume 116
Issue 10
Start page 682
End page 692
Total pages 11
Place of publication New York
Publisher Excerpta Medica/Elsevier
Language eng
Subject 110299 Cardiovascular Medicine and Haematology not elsewhere classified
Abstract Purpose To review the effectiveness of exercise-based cardiac rehabilitation in patients with coronary heart disease. Methods A systematic review and meta-analysis of randomized controlled trials was undertaken. Databases such as MEDLINE, EMBASE, and the Cochrane Library were searched up to March 2003. Trials with 6 or more months of follow-up were included if they assessed the effects of exercise training alone or in combination with psychological or educational interventions. Results We included 48 trials with a total of 8940 patients. Compared with usual care, cardiac rehabilitation was associated with reduced all-cause mortality (odds ratio [OR] = 0.80; 95% confidence interval [CI]: 0.68 to 0.93) and cardiac mortality (OR = 0.74; 95% CI: 0.61 to 0.96); greater reductions in total cholesterol level (weighted mean difference, –0.37 mmol/L [–14.3 mg/dL]; 95% CI: –0.63 to –0.11 mmol/L [–24.3 to –4.2 mg/dL]), triglyceride level (weighted mean difference, –0.23 mmol/L [–20.4 mg/dL]; 95% CI: –0.39 to –0.07 mmol/L [–34.5 to –6.2 mg/dL]), and systolic blood pressure (weighted mean difference, –3.2 mm Hg; 95% CI: –5.4 to –0.9 mm Hg); and lower rates of self-reported smoking (OR = 0.64; 95% CI: 0.50 to 0.83). There were no significant differences in the rates of nonfatal myocardial infarction and revascularization, and changes in high- and low-density lipoprotein cholesterol levels and diastolic pressure. Health-related quality of life improved to similar levels with cardiac rehabilitation and usual care. The effect of cardiac rehabilitation on total mortality was independent of coronary heart disease diagnosis, type of cardiac rehabilitation, dose of exercise intervention, length of follow-up, trial quality, and trial publication date. Conclusion This review confirms the benefits of exercise-based cardiac rehabilitation within the context of today's cardiovascular service provision.
Keyword Medicine
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Nursing, Midwifery and Social Work Publications
 
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Created: Mon, 23 Mar 2009, 22:38:51 EST by Ms Karen Naughton on behalf of School of Nursing, Midwifery and Social Work