Predictors of weight change in cardiac rehabilitation patients

• Main Author: Pimentel, Sabrina; Resident of PMR; Department of PMR, São João Hospital, Porto, Portugal
• Publication Date: 2013
• Other Authors: Rocha, José Afonso; Clinical Assistant of PMR; Cardiac Rehabilitation/Exercise Training Unit, Department of PMR, São João Hospital, Porto, Portugal, Silva, Ana Isabel; Clinical Assistant of PMR; Cardiac Rehabilitation/Exercise Training Unit, Department of PMR, São João Hospital, Porto, Portugal, Parada, Fernando; Director of Department of PMR; Department of PMR, São João Hospital, Porto, Portugal
• Format: Article
• Language: por
• Source: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Download full: https://doi.org/10.25759/spmfr.41

Background: Overweight and its consequences are associated with increased cardiovascular morbidity andmortality. Weight loss significantly contributes to improvement in overall cardiac risk factor profile both inprimary and secondary prevention of coronary heart disease.Objective: To identify predictors of weight change during a hospital-based phase II cardiac rehabilitation programin coronary patients.Methods: Prospective cohort study of 118 patients who completed a phase II cardiac rehabilitation program (CRP)within 3 months after acute coronary syndrome (ACS) recruited between September 2008 and December 2009.Data regarding anthropometric, clinical, laboratorial and functional response was collected at baseline andprogram completion. Psychosocial profile and quality of life were assessed using Patient Health Questionnaire(PHQ-9) and Short-Form 36 (SF-36), respectively. Univariate linear regression was used to identify predictors ofweight change during CRP.Results: We analyzed 118 patients who completed a mean of 14,92(4,32) exercise sessions. They were mostly men108(91,5%) and had low-levels of education. Mean weight loss and mean Body Mass Index (BMI) reduction was0,73(2,56)Kg and 0,27(0,93)Kg/m2 respectively. Body composition showed 1,13(2,91) percent reduction in fat massand 0,45(1,16) percent increase in lean body mass. Independent predictors of weight loss were level of education(b=0,25; p<0,001), smoking status at program entrance (quitters: b=-0,35; p<0,001; persistent smokers b=-0,27;p<0,05), depressive symptoms (b=-0,10; p=0,001; major depression: b=-1,55; p<0,001) and total energyexpenditure during training session (b=0,20; p<0,05).Conclusion: Weight reduction is a reflection of compliance to both dietary and physical activity recommendationsin secondary prevention programs, hence its dependency on level of education, smoking status and estimatedenergy expenditure during physical activity. Weight change is also negatively influenced by psychological factors,mainly depression. Identifying factors associated with poorer weight response might allow earlier, individuallytailored interventions such as more aggressive low-calorie high-expenditure combinations and psychobehaviouralinterventions. Further studies are needed to evaluate the impact of such interventions.Keywords: predictors, weight change, cardiac rehabilitation.