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European Heart Journal 1990 11(8):722-729;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Changes in plasma lipoproteins after cardiac rehabilitation in patients not on lipid-lowering drugs

T. BAARDMAN*,, P. FIORETTI*,{dagger}, A. VAN TOL{ddagger}, R. A. M. ERDMAN*,{dagger},§, H. VAN MEURS-VAN WOEZIK*,{dagger} and M. KAZEMIER*,{ddagger}

*Rotterdam Foundation for Cardiac Rehabilitation The Netherlands
{dagger}Thoraxcenter, Erasmus University Rotterdam The Netherlands
{ddagger}Department of Biochemistry I, Erasmus University Rotterdam The Netherlands
§Department of Medical Psychology and Psychotherapy, Erasmus University Rotterdam The Netherlands

Received 9 June 1989; revised 19 October 1989; .

Address for correspondence: Drs Taco Baardman, Rotterdamse Stichting voor Cardiologische Revalidatie, Parklaan 38, 3016 BC Rotterdam, The Netherlands.

Abstract

The extent to which a conventional cardiac rehabilitation programme can influence plasma lipoproteins was investigated in a prospective study. The relationship between changes in plasma lipoproteins and baseline characteristics, as well as variables related to the physical training and to dietary habits were assessed in 77 cardiac patients. All patients participated in a physical training programme, including general dietary advice. Patients who received lipid-lowering drugs were excluded from this study.

Total plasma cholesterol decreased from 7.1 ±1.6 to 6.8 ±1.2 mmol l–1 (P < 0.05), but it remained high in many patients, 61% having a level above 6.5 mmol l–1. The high and low-density lipoprotein fractions (HDL-and LDL-cholesterol), and the ratio of total cholesterol to HDL-cholesterol, did not change significantly. The change in total plasma cholesterol was greatest (P< 0.05) in patients who changed their diet in the recommended direction, and was poorly related to the change in maximal workload.

It is concluded that a combination of general dietary advice and moderate physical exercise training is followed by a small reduction in total plasma cholesterol levels without changing HDL-cholesterol, and that cardiac rehabilitation should include strict programmes for the reduction of elevated plasma cholesterol.

Key Words: Cardiac rehabilitation • plasma lipoproteins


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