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Controlled Clinical Trial
. 2014 Apr;73(4):748-51.
doi: 10.1136/annrheumdis-2013-203291. Epub 2013 Jul 31.

Individualised exercise improves endothelial function in patients with rheumatoid arthritis

George S Metsios  1 , Antonios Stavropoulos-Kalinoglou, Jet J C S Veldhuijzen van Zanten, Peter Nightingale, Aamer Sandoo, Theodoros Dimitroulas, George D Kitas, Yiannis Koutedakis
Affiliations
Controlled Clinical Trial

Individualised exercise improves endothelial function in patients with rheumatoid arthritis

George S Metsios et al. Ann Rheum Dis. 2014 Apr.

Abstract

Background: We investigated the effects of individualised combined resistance and aerobic exercise on microvascular and macrovascular function in rheumatoid arthritis (RA) patients.

Methods: Forty age-matched, gender-matched and body mass index (BMI)-matched patients were allocated to either an exercise group, receiving a 6 months tailored aerobic and resistance exercise intervention, or controls receiving only information about the benefits of exercise. Participants were assessed for microvascular (acetylcholine (Ach) and sodium nitroprusside (SNP)) and macrovascular (flow-mediated dilatation (FMD) and glyceryl trinitrate (GTN)) endothelial function, maximal oxygen uptake, disease activity and severity (C-reactive protein (CRP), disease activity score 28 and health assessment questionnaire). Data were collected at baseline, 3 months and at the end of the intervention (6 months).

Results: At baseline, demographic, anthropometric, disease-related characteristics and endothelial function parameters were similar between the exercise and control groups (p>0.05). Repeated measures analysis of variance revealed a significant improvement in endothelial function parameters at 3 (GTN: p<0.001) or 6 months (Ach: p=0.016, SNP: p=0.045, FMD: p=0.016) in the exercise but not in the control group. Generalised estimated equations detected that maximal oxygen uptake was a strong predictor for the observed changes in Ach (p=0.009) and GTN (p<0.001) whereas logCRP for SNP (p=0.017) and GTN (p=0.008).

Conclusions: An exercise programme designed to meet individual needs and physical abilities significantly improves microvascular and macrovascular function in parallel with disease-related characteristics in RA patients. The potential long-term beneficial effects of such interventions at reducing cardiovascular risk in these patients merit further exploration.

Clinical trial registration: ISRCTN50861407.

Keywords: Cardiovascular Disease; Inflammation; Rehabilitation; Rheumatoid Arthritis.

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