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    Cardiac Rehab Improves Risk Factors in Patients With Stroke, Says Stroke Study

    A cardiac rehabilitation program is a safe, feasible, and effective intervention for some stroke patients, says a Heartwire article based on research published this month in Stroke.

    Most of the patients in the study were sedentary, hypertensive, hyperlipidemic, or had a history of smoking. The intervention included education about these risk factors, diet, and medications; advice regarding psychological issues; and a stress test. Patients had the option of an onsite exercise program, consisting of 50 twice-weekly exercise sessions with supplementary home-based training at least twice weekly, or a home-based option, with exercise at least 4 days weekly and monthly contact by phone or onsite.

    At the end of the study, there was a 31.4% increase in mean aerobic capacity. The proportion of patients who met a functional target of >7 metabolic equivalents significantly increased from 35.1% to 64.6%.

    The lipid profile of patients also improved. Total cholesterol (TC) dropped by 6.8%, LDL cholesterol by 10.3%, triglycerides by 16.5%, and TC/HDL ratio by 11.6%, while HDL cholesterol increased by 4.4%. All changes were significant, except LDL and HDL cholesterol, which approached significance, Heartwire says.

    Mean waist circumference, BMI, and body weight showed small but significant decreases. Seven of the 14 smokers had quit smoking by the end of the study. Medication use did not significantly change, nor did mean fasting blood glucose or systolic or diastolic blood pressure.

    Among a subset of patients with diabetes, only 17.4% at intake and 23.8% at exit met the blood pressure target, a "concerning observation" for the authors who recommend closely monitoring  this subgroup of patients, as diabetes and hypertension are 2 key vascular risk factors, the article says.


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