Comprehensive Cardiovascular Risk Reduction and Cardiac Rehabilitation in Diabetes and the Metabolic Syndrome.
The epidemic of obesity has contributed to a growing burden of metabolic syndrome (MetS) and diabetes mellitus (DM) worldwide. MetS is defined as central obesity along with associated factors such as hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, and hypertension. MetS and DM are associated with significant cardiovascular morbidity and mortality. Healthy behavioural modification is the cornerstone for reducing the atherosclerotic cardiovascular disease burden in this population. Comprehensive, multidisciplinary cardiac rehabilitation (CR) programs reduce mortality and hospitalizations in patients with MetS and DM. Despite this benefit, patients with MetS and DM are less likely to attend and complete CR because of numerous barriers. Implementation of innovative CR delivery models might improve utilization of CR and cardiovascular outcomes in this high-risk population.
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Robert E
RE
Heinl
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Devinder S
DS
Dhindsa
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Elliot N
EN
Mahlof
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
William M
WM
Schultz
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Johnathan C
JC
Ricketts
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Tina
T
Varghese
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Amirhossein
A
Esmaeeli
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Marc P
MP
Allard-Ratick
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Anthony J
AJ
Millard
Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA.
Heval M
HM
Kelli
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Pratik B
PB
Sandesara
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA; Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA.
Danny J
DJ
Eapen
Division of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA; Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA. Electronic address: lsperli@emory.edu.
Laurence
L
Sperling
D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D048909:Diabetes Complications; D038441:Diet, Mediterranean; D015444:Exercise; D006760:Hospitalization; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications*; D009765:Obesity / Q000150:complications*; D040242:Risk Reduction Behavior
Heart Lung Circ. 2016 Aug;25(8):802-7
27262389
Diabetes Metab Syndr Obes. 2014 Feb 24;7:65-72
24591844
J Am Coll Cardiol. 2013 Aug 20;62(8):697-703
23810877
N Engl J Med. 2002 Feb 7;346(6):393-403
11832527
Annu Rev Nutr. 2015;35:425-49
25974696
J Am Coll Cardiol. 2015 Feb 3;65(4):389-395
25634839
J Law Med Ethics. 2008 Winter;36(4):772-89, 611
19094006
J Am Coll Cardiol. 2011 Mar 15;57(11):1299-313
21392646
Eur Heart J. 2007 Apr;28(7):857-64
17303589
Ann Intern Med. 2006 Jul 4;145(1):1-11
16818923
Sports Med. 2015 May;45(5):679-92
25771785
J Cardiovasc Nurs. 2016 May-Jun;31(3):E10-22
26544175
Health Rep. 2002;13(3):9-14
12743956
Circulation. 2004 Sep 7;110(10):1245-50
15326067
Am J Cardiol. 2007 Dec 15;100(12):1759-66
18082522
N Engl J Med. 2007 May 17;356(20):2017-21
17507699
Circulation. 2006 Feb 14;113(6):791-8
16461820
Heart Lung Circ. 2015 Feb;24(2):149-57
25306500
Diabetologia. 1991 Jul;34(7):457-62
1916049
Circulation. 2010 Jan 5;121(1):63-70
20026778
Can J Cardiol. 2016 Nov;32(11):1316-1324
27129618
N Engl J Med. 2009 Jun 11;360(24):2503-15
19502645
N Engl J Med. 2008 Jul 17;359(3):229-41
18635428
Lancet. 1998 Jun 13;351(9118):1755-62
9635947
Am J Cardiol. 2005 Aug 22;96(4A):8E-10E
16098836
BMJ Open. 2016 Mar 21;6(3):e010214
27000785
Diabetes Obes Metab. 2010 Mar;12(3):204-9
20151996
Eur Urol. 2009 Jan;55(1):249-50
20050018
Diabetes. 2005 Jun;54(6):1706-16
15919792
Int J Equity Health. 2013 Aug 28;12:72
23985017
Circulation. 1999 Feb 16;99(6):779-85
9989963
Lancet. 1998 Sep 12;352(9131):837-53
9742976
Heart Lung Circ. 2016 Feb;25(2):166-74
26375499
J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2960-84
24239922
Obesity (Silver Spring). 2013 Sep;21(9):E439-47
23687099
J Appl Physiol (1985). 2005 Oct;99(4):1613-8
16002776
Circulation. 2009 Oct 20;120(16):1640-5
19805654
Diabetologia. 2001 Sep;44 Suppl 2:S54-64
11587051
N Engl J Med. 2002 Mar 14;346(11):793-801
11893790
N Engl J Med. 2018 Jun 21;378(25):2441-2442
29897867
Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007130
20091618
N Engl J Med. 2003 Jan 30;348(5):383-93
12556541
J Am Coll Cardiol. 2016 Jan 5;67(1):13-5
26764060
CMAJ. 2011 Oct 18;183(15):E1127-34
21911558
Circulation. 2012 Sep 25;126(13):1587-95
22929302
Public Health Nutr. 2009 Sep;12(9A):1607-17
19689829
Adv Cardiol. 2008;45:1-16
18230953
N Engl J Med. 1999 Aug 5;341(6):427-34
10432328
Diabetologia. 2001 Sep;44 Suppl 2:S14-21
11587045
Am Heart J. 2016 Mar;173:108-17
26920603
Eur Heart J. 2007 Mar;28(5):540-5
17289742
Eur J Clin Nutr. 2015 Nov;69(11):1200-8
25369829
Endocrinology. 2003 Jun;144(6):2195-200
12746274
Cochrane Database Syst Rev. 2015 Sep 07;(9):CD002098
26343551
Obes Rev. 2016 May;17(5):442-54
26990451
Physiol Rev. 2013 Jan;93(1):359-404
23303913
Diabetes Care. 2016 May;39(5):694-700
27006512
Ann Intern Med. 2009 Sep 1;151(5):306-14
19721018
Circulation. 2004 Jan 27;109(3):433-8
14744958
JAMA. 2004 Sep 22;292(12):1440-6
15383514
Heart. 2016 Aug 1;102(15):1183-92
26936337
Stroke. 2008 Apr;39(4):1078-83
18323501
N Engl J Med. 2001 May 3;344(18):1343-50
11333990
Diabetes Care. 2011 Jul;34(7):1481-6
21593294
Circulation. 2014 Jan 21;129(3):e28-e292
24352519
JAMA. 2002 Dec 4;288(21):2709-16
12460094
N Engl J Med. 2013 Jul 11;369(2):145-54
23796131
Br J Nutr. 2004 Sep;92(3):347-55
15469638
Diab Vasc Dis Res. 2013 Nov;10(6):505-13
23975724
Nutr Rev. 2009 Feb;67(2):114-20
19178654
Circulation. 2013 Jan 1;127(1):143-52
23283859
Prog Cardiovasc Dis. 2014 Mar-Apr;56(5):522-9
24607017
High Blood Press Cardiovasc Prev. 2016 Sep;23(3):187-96
27072129
J Res Med Sci. 2016 Mar 15;21:18
27904564
Heart. 2016 Jun 15;102(12):904-9
26941396
J Appl Physiol (1985). 2015 Jun 15;118(12):1474-82
25882384
J Nutr. 2015 Apr 1;146(4):920S-927S
26962178
Circulation. 2011 Dec 20;124(25):2951-60
22082676
N Engl J Med. 2008 Feb 7;358(6):580-91
18256393
J Cardiometab Syndr. 2008 Summer;3(3):136-40
18983328
Br Med Bull. 2001;60:33-50
11809617
Circulation. 2000 Aug 15;102(7):722-7
10942738
J Am Coll Cardiol. 2015 Sep 1;66(9):1050-67
26314534
PeerJ. 2016 Jan 14;4:e1554
26788432
Phys Ther. 2010 Oct;90(10):1373-82
20889928
Circulation. 2003 Jul 29;108(4):414-9
12860911
Diabetes. 2005 Jun;54(6):1615-25
15919781
Diabetes Care. 2004 Oct;27(10):2444-9
15451914
Diabetologia. 2015 Apr;58(4):691-8
25742772