title: Individualised aerobic and resistance exercise training improves cardiorespiratory fitness and reduces cardiovascular risk in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Low cardiorespiratory fitness (CRF) is a significant predictor of cardiovascular disease (CVD), and interventions aiming at increasing CRF are known to reduce CVD risk. The effects of such interventions on CVD risk have not been studied in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  40 age, gender, body mass index (BMI) and disease duration matched RA patients were allocated to either an exercise (receiving 6 months individualised aerobic and resistance high intensity exercise intervention, three times per week), or control (receiving advice on exercise benefits and lifestyle changes) arm. Participants were assessed at baseline, 3 and 6 months for aerobic capacity (VO2max), individual CVD risk factors (blood pressure, lipids, insulin resistance, body composition), 10-year CVD event probability and RA characteristics (C-reactive protein (CRP), Disease Activity Score 28 (DAS28) and Health Assessment Questionnaire (HAQ)).
  
  
  RESULTS
  There were no differences between groups at baseline in any of the assessed variables. VO2max (p=0.001), blood pressure (systolic: p<0.001; diastolic: p=0.003), triglycerides (p=0.030), high density lipoprotein (HDL; p=0.042), total cholesterol:HDL ratio (p=0.005), BMI (p=0.001), body fat (p=0.026), 10-year CVD event probability (p=0.012), CRP (p=0.042), DAS28 (p=0.008) and HAQ (p=0.003) were all significantly improved in the exercise versus the control group. The change in VO2max was the strongest predictor for the observed improvements in all of the assessed CVD risk factors and disease characteristics.
  
  
  CONCLUSIONS
  Individualised aerobic and resistance exercise intervention can lead to significantly improved CRF, individual CVD risk factors, composite CVD risk, and disease activity and severity in RA patients.
authors.affiliation: Department of Rheumatology, Dudley Group NHS Foundation Trust, Russell's Hall Hospital, Dudley, UK.
authors.forename: Antonios
authors.initials: A
authors.lastname: Stavropoulos-Kalinoglou
authors.forename: Giorgos S
authors.initials: GS
authors.lastname: Metsios
authors.forename: Jet J J C S
authors.initials: JJ
authors.lastname: Veldhuijzen van Zanten
authors.forename: Peter
authors.initials: P
authors.lastname: Nightingale
authors.forename: George D
authors.initials: GD
authors.lastname: Kitas
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Koutedakis
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001794:Blood Pressure; D002097:C-Reactive Protein; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055070:Resistance Training / Q000379:methods; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002097:C-Reactive Protein