Does Lifestyle Exercise After a Cardiac Event Improve Metabolic Syndrome Profile in Older Adults?
Kathy D Wright, Laura Moore-Schiltz, Abdus Sattar and 2 others
PMID 29634648WHAT IT FOUND
Older adults after a cardiac event who logged at least 130 hours of lifestyle exercise in a year were 3.6 times more likely to reduce their number of metabolic syndrome factors by at least one than those who did not.
Key findings
01Participants who exercised at least 130 hours over the study year were 3.6 times more likely to reduce their number of metabolic syndrome factors by at least one than participants who did not meet that amount.
02Among participants who improved their metabolic syndrome profile, 60.6% met the exercise guideline, compared with 37.4% among participants who did not improve.
03In the improved group, HDL increased in 72% of participants, and waist circumference and glucose each reduced in 60.6%, while few participants had blood pressure reductions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of a parent randomized trial, and lifestyle exercise was not randomly assigned, so the exercise-outcome association cannot prove cause. Participants had already completed supervised cardiac rehabilitation and were assigned to behavior change interventions or usual care, so the analysis cannot separate lifestyle exercise from those earlier supports. Only 116 of the parent study's 379 participants had complete metabolic syndrome data, and 236 were excluded for incomplete blood samples, so the analyzed group may not represent all cardiac rehabilitation participants. The sample was mostly white males and NYHA Class I, with fewer minorities than the parent study, limiting generalization to women, more disabled patients, and other populations. The authors state the improvements were statistically significant but could not support clinical significance, so the size of the metabolic syndrome change may not matter for patient outcomes. The analysis was limited to variables collected in the original study, so it could not account for how long participants had metabolic syndrome factors, family history, or the pattern of exercise across the year.
The easy way to misread this
Do not conclude that lifestyle exercise was shown to clinically improve metabolic syndrome after a cardiac event. This was a secondary analysis of self-selected exercise in 116 mostly white male participants, and the authors state the improvements were statistically significant but not shown to be clinically significant.