Key words: cardiorespiratory fitness, coronary artery disease, systematic review
This blog summarises a recent study published in BJSM (1).
Why is this study important?
Coronary artery disease (CAD) is the leading cause of death worldwide. While medical treatments like percutaneous coronary intervention have lowered the number of deaths in patients with CAD, these treatments do not address the underlying risk of atherosclerosis. In fact, 20% of patients who survive a heart attack experience another cardiovascular event within a year. Both aerobic and resistance training are recommended for patients with CAD, but it was unclear how combining these two types of exercise affects cardiovascular disease risk factors. Our study aimed to fill this gap to find better exercise recommendations to prevent future events in patients with CAD.
How did the study go about this?
We conducted a systematic review of randomized controlled trials comparing the effects of aerobic and resistance combined training with aerobic training alone on various health indicators in patients with CAD. These indicators included cardiorespiratory fitness (CRF), body weight, fat mass, lean mass, waist circumference, blood glucose and lipids level. Of 17,438 studies identified, we reviewed 23 that met our inclusion criteria, involving 916 participants with CAD. We combined the data from these studies and compared the effects of combined training to aerobic training alone on cardiovascular disease risk factors.
What did the study find?
We found that combined training improved CRF, lean mass, and percent body fat more than aerobic training alone. We also divided the studies into two groups: one where resistance training was added without reducing aerobic training volume, and another where some aerobic training was replaced with resistance training. Our results showed that CRF improvements were only significant when resistance training was added without reducing aerobic training volume.
What are the key take-home points?
Improving CRF is crucial for preventing future heart problems in patients with CAD, as better CRF is strongly linked to lower cardiovascular mortality. To get the most improvement in CRF, resistance training should be added to aerobic training without reducing aerobic training volume. If time constraints make this difficult, replacing some aerobic exercise with resistance training still maintains CRF benefits. Adding resistance training into cardiovascular rehabilitation programs can significantly improve both CRF and body composition in patients with CAD.
Authors: Tasuku Tarada
References:
- Terada T, Pap R, Thomas A, et al. Effects of muscle strength training combined with aerobic training versus aerobic training alone on cardiovascular disease risk indicators in patients with coronary artery disease: a systematic review and meta-analysis of randomised clinical trials British Journal of Sports Medicine 2024;58:1225-1234.