Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Dec;140(6):1420-1427.
doi: 10.1378/chest.10-3289. Epub 2011 Jul 21.

The effect of weight loss and exercise training on flow-mediated dilatation in coronary heart disease: a randomized trial

Philip A Ades  1 , Patrick D Savage  2 , Stefan Lischke  2 , Michael J Toth  2 , Jean Harvey-Berino  3 , Janice Y Bunn  4 , Maryann Ludlow  3 , David J Schneider  2
Affiliations
Randomized Controlled Trial

The effect of weight loss and exercise training on flow-mediated dilatation in coronary heart disease: a randomized trial

Philip A Ades et al. Chest. 2011 Dec.

Abstract

Background: More than 80% of patients entering cardiac rehabilitation are overweight, with a high prevalence of associated insulin resistance, diabetes, hypertension, hyperlipidemia, and a prothrombotic state. Because each of these characteristics is associated with abnormalities of endothelial-dependent flow-mediated dilatation (FMD), a predictor of long-term prognosis in patients with coronary heart disease (CHD), we assessed the effect of exercise training and weight reduction on FMD in overweight patients with CHD.

Methods: All patients (N = 38) participated in behavioral weight loss while taking their usual preventive medications. Subjects were randomized to one of two exercise protocols, which differed by caloric expenditure. The primary outcome was extent (%) of brachial artery FMD measured by ultrasonography before and after the 4-month exercise and weight-loss program.

Results: Both study groups experienced an increase in brachial artery FMD after weight loss and exercise. Patients randomized to the higher-caloric exercise condition (longer-distance walking) lost more weight (8.6 ± 4.1 kg vs 2.3 ± 3.3 kg [P < .001]) and experienced a greater percentage increase in brachial artery FMD (3.6% ± 4.1% vs 1.3% ± 2.1%, P < .05) than did subjects in the lower-caloric-expenditure exercise group who lost less weight. Both groups increased peak aerobic capacity similarly. Increased FMD correlated with changes in body weight more than with measures of abdominal fat, glucose disposal, lipid measure, BP, or measures of physical activity or cardiorespiratory fitness.

Conclusions: Exercise and weight loss increased FMD in overweight and obese patients with CHD. Greater weight reduction was associated with a greater improvement in FMD; thus, there was a dose effect.

Trial registry: ClinicalTrials.gov; No.: NCT00628277; URL: www.clinicaltrials.gov.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Change in FMD by study group (± SD). CR = cardiac rehabilitation; Ex = exercise; FMD = flow-mediated dilatation; Mths = months.
Figure 2.
Figure 2.
FMD by quintiles of weight loss (± SD). See Figure 1 legend for expansion of the abbreviation.
See this image and copyright information in PMC

Comment in

References

    1. Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med. 2004;116(10):682–692. - PubMed
    1. Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med. 2001;345(12):892–902. - PubMed
    1. Keteyian SJ, Brawner CA, Savage PD, et al. Peak aerobic capacity predicts prognosis in patients with coronary heart disease. Am Heart J. 2008;156(2):292–300. - PubMed
    1. Kavanagh T, Mertens DJ, Hamm LF, et al. Prediction of long-term prognosis in 12 169 men referred for cardiac rehabilitation. Circulation. 2002;106(6):666–671. - PubMed
    1. Kavanagh T, Mertens DJ, Hamm LF, et al. Peak oxygen intake and cardiac mortality in women referred for cardiac rehabilitation. J Am Coll Cardiol. 2003;42(12):2139–2143. - PubMed

Publication types

MeSH terms

Associated data