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Exercise Capacity of Overweight Non-diabetic Coronary Artery Disease Patients

by Amrita Surendranath on  December 13, 2015 at 3:14 PM Health In Focus   - G J E 4
Exercise is essential for everyone,especially for patients with coronary artery disease (CAD) even though there is a general notion that such patients should be under complete rest to prevent any additional stress to the heart. Patients are also concerned about the effect of their body composition (more so if they are overweight) and insulin sensitivity on their ability to exercise, worrying about 'burdening' their body. Scientists have now found conclusive evidence to lay their fears to rest, cautiously.
 Exercise Capacity of Overweight Non-diabetic Coronary Artery Disease Patients
Exercise Capacity of Overweight Non-diabetic Coronary Artery Disease Patients
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While it is true that caution and discretion should be exercised before any strenuous physical activity and that any exercise routine should be started only after consultation with a medical doctor, the following are some of the benefits of exercise for people with coronary artery disease.

‘Being overweight and sensitive to insulin does not affect exercise capacity of coronary artery disease patients.’
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a) Strengthening of heart muscles

b) Makes the person active with reduction in chest pain and associated symptoms

c) Reduction in blood pressure

d) Lowered LDL cholesterol

e) Increase in HDL cholesterol

f) Lowered blood sugar among diabetics

g) Improved bone strength

h) Reduction in weight among overweight individuals and helps boost their self-esteem

Apart from the health benefits, the exercise capacity of a CAD patient aids in determining prognosis of the disease.

i) Lowered exercise capacity is witnessed among patients with stable coronary artery disease with normal left ventricular ejection fraction

ii) Decreased exercise capacity is seen among patients with visceral obesity

iii)Reduced exercise capacity is seen among patients with coronary microvascular function

Coronary microvascular function is emerging as a good predictor of poor prognosis among patients with coronary artery disease. Coronary microvascular function is impaired in coronary artery disease patients who have any of the following

1. Diabetes

2. Hypertension

3. Visceral obesity

The significance of exercise among coronary artery patients prompted scientists Anders Jurs and colleagues to carry out their research which is published under the title "Coronary microvascular function, insulin sensitivity and body composition in predicting exercise capacity in overweight patients with coronary artery disease" in BMC Cardiovascular Diseases in November 2015. In this study, the scientists set out to understand the effect of insulin sensitivity and body composition on the association between coronary microvascular function and exercise capacity among patients who are overweight, non-diabetic and with coronary artery disease.

The patients under study were provided with low energy diet and aerobic interval training that helped them achieve weight loss, while their heart parameters, insulin sensitivity and body composition were monitored, before, during and after the study.

The extensive study found no association between insulin resistance and body composition in determining exercise capacity. Since exercise capacity is an indicator of poor prognosis among cardiac patients, from this study it is evident that body composition and insulin resistance should not be the limiting factors for exercise even among coronary artery disease patients.

This would be a great boost for cardiac patients who believed that they should limit exercise owing to their girth or insulin sensitivity. Further, newly diagnosed cardiac patients have been found to return to work sooner, feel more confident and are filled with a lot more energy than patients who do not exercise.

Jonathan Myers from the Palo Alto Health care system states in his paper titled 'exercise and cardiovascular health' that cardiac patients who are part of a formal exercise program reduce their death rate by 20 to 25%.

There are certain risks associated with exercise but the percentage is very low, nevertheless, it is important to understand that they do exist. Monitored exercises, that begin with 15 to 30 minutes of brisk walking would be an ideal start. Once the body starts to get used to the exercise regime, it will become an integral part of the daily routine. The most important step is to enroll in a suitable program. It will help banish the blues and boost energy levels, which will make them feel less as a patient and more in control.

References

1) Anders Jurs, Lene, Rorholm Peterson, Rasmus Huan Olsen, Martin Snoer, Elizaveta Chabanova, Steen Bendix Haugaard and Eva Prescott; " Coronary microvascular function, insulin sensitivity and body composition in predicting exercise capacity in overweight patients with coronary artery disease", BMC Cardiovascular disorders, 2015 2) Jonathan Myers; "Exercise and cardiovascular health", circulation, 2003

Source: Medindia
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