Dietary measures and exercise training contribute to improvement of endothelial function and atherosclerosis even in patients given intensive pharmacologic therapy.

Sammy Y Chan, G B John Mancini, Susanne Burns, Frances F Johnson, Anka P Brozic, Kori Kingsbury, Sandra Barr, Lisa Kuramoto, Michael Schulzer, Jiri Frohlich, Andrew Ignaszewski
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引用次数: 30

Abstract

Purpose: Atherosclerosis contributes to cardiovascular mortality and morbidity even with aggressive lipid management. Our objective is to determine whether a combined pharmacological and lifestyle intervention can improve atherosclerosis.

Methods: We conducted a 2-year observational study at a specialized clinic in a tertiary care hospital. One hundred fifty-six subjects with coronary disease were enrolled in an intensive pharmacological management and lifestyle measures (including counseling and exercise training) program designed to reach specific targets. The main outcome measures were carotid intima media thickness and plaque area; brachial artery flow-mediated dilation; nitroglycerin-mediated dilation; flow-mediated dilation-nitroglycerin-mediated dilation ratio; laboratory parameters including lipids, glucose, creatinine, and homocysteine; and physical fitness.

Results: At completion, there were improvements in lipids and physical fitness. There were no overall changes in flow-mediated dilation, nitroglycerin-mediated dilation, or carotid intima media thickness in the entire cohort. However, multivariate logistic regression showed that dietary and exercise variables, such as increasing fiber intake and reducing body weight and body fat percentage, were independent predictors of improvements in endothelial function and carotid plaque burden.

Conclusions: Even in the setting of intensive pharmacological therapy, lifestyle interventions, including exercise training and dietary changes, are important determinants of improved endothelial function and atherosclerosis.

即使在接受强化药物治疗的患者中,饮食措施和运动训练也有助于改善内皮功能和动脉粥样硬化。
目的:动脉粥样硬化导致心血管死亡率和发病率,即使采取积极的脂质管理。我们的目的是确定联合药物和生活方式干预是否可以改善动脉粥样硬化。方法:在某三级医院专科门诊进行为期2年的观察性研究。156名冠心病患者参加了一项旨在达到特定目标的强化药理学管理和生活方式措施(包括咨询和运动训练)计划。主要观察指标为颈动脉内膜中膜厚度和斑块面积;肱动脉血流介导扩张;nitroglycerin-mediated扩张;血流介导的扩张-硝酸甘油介导的扩张比;实验室参数包括血脂、葡萄糖、肌酐和同型半胱氨酸;还有身体健康。结果:完成后,血脂和体能均有改善。在整个队列中,血流介导的扩张、硝酸甘油介导的扩张或颈动脉内膜中膜厚度没有总体变化。然而,多变量logistic回归显示,饮食和运动变量,如增加纤维摄入量、降低体重和体脂率,是内皮功能和颈动脉斑块负担改善的独立预测因素。结论:即使在强化药物治疗的情况下,生活方式干预,包括运动训练和饮食改变,是改善内皮功能和动脉粥样硬化的重要决定因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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