title: Impact of Community-Based Cardiac Rehabilitation on Clinical Parameters of Patients with Cardiovascular Diseases.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) programmes have been shown to improve patient outcomes, but vary widely in their components. The impact of Singapore's CR programme on clinical outcomes is currently not known.
  
  
  OBJECTIVE
  To evaluate the effects of a community-based CR programme on important clinical parameters in patients with cardiovascular disease in Singapore.
  
  
  METHODS
  A retrospective cohort study was conducted. Cardiovascular patients who had completed a hospital-based CR programme were included. Patients who continued with community-based CR (n = 94) during the period of 2009-2013 were compared with patients who received regular care (n = 157). Changes in clinical and physical examination parameters between baseline and one-year post follow-up were analyzed. Within-group differences were compared using the paired t-test, while multivariate linear regression was used to compare the changes in the various parameters between the intervention and control groups. The primary outcome measure was low density lipoprotein (LDL) levels.
  
  
  RESULTS
  Patients in the intervention group had significant lowering of LDL (2.5 to 2.2 mmol/L, p<0.01), while the control group's LDL increased (2.2 to 2.4 mmol/L, p<0.01). The intervention group had greater improvements in LDL (-0.3 vs. +0.2 mmol/L, p<0.01), triglycerides (-0.1 vs. +0.1 mmol/L, p=0.01), total cholesterol (-0.3 vs. +0.3 mmol/L, p<0.01), fasting blood glucose (-0.5 vs. +0.3 mmol/L, p<0.01), systolic blood pressure (-3.2 vs. +5 mmHg, p<0.01) and diastolic blood pressure (-2.6 vs. +2.8 mmHg, p<0.01).
  
  
  CONCLUSIONS
  The community-based CR programme in Singapore is associated with improvements in several cardiovascular clinical parameters and may be of benefit to cardiovascular patients.
authors: Department of Pharmacy, Singapore General Hospital, Republic of Singapore, Singapore.
authors: Kheng Yong
authors: KY
authors: Ong
authors: Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore, Singapore.
authors: Elise
authors: E
authors: Yap
authors: Duke-NUS Medical School, 8 College Road, Republic of Singapore, 169857 Singapore.
authors: Yvonne
authors: Y
authors: May Fen Chia
authors: Heart Wellness Centre, Singapore Heart Foundation, Republic of Singapore, Singapore.
authors: Hung Yong
authors: HY
authors: Tay
authors: Department of Cardiology, National Heart Centre Singapore, Republic of Singapore, Singapore.
authors: Peter
authors: P
authors: Ting
authors: Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore, Singapore.
authors: Sui Yung
authors: SY
authors: Chan
authors: Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore, Singapore ; Duke-NUS Medical School, 8 College Road, Republic of Singapore, 169857 Singapore ; Heart Wellness Centre, Singapore Heart Foundation, Republic of Singapore, Singapore.
authors: Yu Heng
authors: YH
authors: Kwan
keywords: Cardiac Rehabilitation; Cardiovascular Disease; Clinical Outcomes; Community; Low density lipoprotein