title: Effect of cardiac rehabilitation on metabolic syndrome and its components: A systematic review and meta-analysis.
abstract: BACKGROUND
  Although the effect of cardiac rehabilitation (CR) on cardiovascular disease (CVD) prognosis has been well-documented by several systematic reviews, none have focused on the effect of CR on metabolic syndrome (MetS) and its related components. Therefore, the present systematic review and meta-analysis was conducted to assess the effect of CR on MetS and its components.
  
  
  METHODS
  PubMed, SCOPUS, Cochrane library, and Google Scholar database were searched up to February 2014 with no date and language restrictions. The random effects model was used to assess the overall effect of CR on MetS prevalence and the change in metabolic or anthropometric measures.
  
  
  RESULTS
  Fifteen studies with 19,324 subjects were included in the present systematic review and meta-analysis. Our analysis showed that the CR could significantly reduce MetS prevalence [reduction rate: 0.25, 95% confidence interval (CI): 0.21, 0.3,Pvalue <0.001;Pvalue for heterogeneity <0.001, I-squared: 86.2%]. Additionally, results showed the protective role of CR on all MetS components including high density lipoprotein cholesterol [mean difference (MD): 2.13 mg/dL, 95% CI: 1.17, 3.1], triglyceride (MD: -27.45 mg/dL, 95% CI: -36.92, -17.98), systolic blood pressure (SBP) (MD: -6.20 mmHg, 95% CI: -8.41, -3.99), diastolic blood pressure (DBP) (MD: -2.53 mmHg, 95% CI: -3.64, -1.41), fasting blood sugar (FBS) (MD: -6.42 mg/dL, 95% CI: -6.85, -5.99), and waist circumference (WC) (MD: -2.25 cm, 95% CI: -3.15, -1.35).
  
  
  CONCLUSIONS
  CR has resulted in improvement in MetS and its entire components, and could be considered as a useful tool for MetS patients, especially among those with CVD.
authors.affiliation: Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Yazd, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Salehi-Abargouei
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Kasaei
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Sajjadieh-Khajooie
authors.affiliation: Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heidari
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Roohafza
keywords: Cardiac rehabilitation (CR); meta-analysis; metabolic factors; syndrome x