Physical performance is associated with markers of vascular inflammation in patients with coronary heart disease.
BACKGROUND
Coronary heart disease as well as major cardiovascular risk factors are associated with elevated levels of pro-inflammatory markers. There is, however, limited information about how changes in lifestyle improving the cardiovascular risk profile influence these levels. The aim of the study was to evaluate whether changes in lifestyle measures with special attention to physical activity, were associated with the levels of such markers.


METHODS
Coronary heart disease patients (n = 197) were randomized to either a comprehensive lifestyle intervention programme comprising regular physical activity, low fat diet and smoking cessation, or usual care with routine follow-up in the outpatient clinic for 6 months. An exercise test and fasting blood samples analysed for soluble cell adhesion molecules, C reactive protein and pro-inflammatory cytokines were evaluated before and at the end of the study.


RESULTS
Improved diet, physical performance and reduction in smoking were obtained in the intervention programme when compared with usual care patients, but no significant group differences in levels of inflammatory markers were observed. In the total population, however, physical performance significantly and inversely predicted levels of soluble cell adhesion molecule 1, (P < 0.001), C-reactive protein (P < 0.001) and interleukin-6 (P = 0.01) at 6 months. Smokers had elevated levels of soluble cell adhesion molecule 1 when compared with non-smokers (P = 0.011).


CONCLUSIONS
We demonstrated that physical performance is inversely correlated with levels of pro-inflammatory markers in coronary heart disease patients, possibly retarding the process of atherosclerosis. No effect on inflammatory markers was obtained with a 6-month lifestyle intervention programme when compared with patients who received usual care follow-up.
Schumacher
Anita
A
Division of Cardiology and Department of Microbiology, Hospital of Vestfold, Tønsberg, Norway. anita.schumacher@siv.no
Peersen
Kari
K
Sommervoll
Lisbeth
L
Seljeflot
Ingebjørg
I
Arnesen
Harald
H
Otterstad
Jan Erik
JE
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003327:Coronary Disease / Q000097:blood / Q000628:therapy*; D004032:Diet; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012907:Smoking; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein