Impact of structured cardiac rehabilitation on metabolic profile and functional capacity in secondary prevention
R Fernandes Da Silva, R Louro, P Correia, R Viana, M Paralta De Figueiredo, R Almeida Pinto, A Narra, T Costa, A Rita Raposinho, M Rangel, H Marreiros, J Pais, R Rocha, M Trinca, L PatricioAbstract
Introduction
Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary intervention that combines supervised exercise, patient education and behavioral change strategies to support optimal therapy adherence. CR has consistently demonstrated benefits in improving functional capacity, promoting better control of cardiovascular risk factors and reducing the long-term impact of heart disease. Understanding the real-world effects of structured CR programs is therefore essential to support broader implementation in routine practice.
Purpose
To evaluate the effects of a center-based CR program on functional capacity and metabolic risk markers in secondary prevention patients.
Methods
We analyzed 35 patients who completed a 12-week center-based CR program comprising 24 supervised exercise and 8 educational sessions. Enrollment was limited to low-risk patients. Demographic data, comorbidities, laboratory biomarkers, and exercise test parameters were collected before and after the program. Pre-post differences were evaluated using paired-samples t-tests.
Results
Participants were mainly male (77%) with a mean age of 61.6±9.9 years and a high burden of cardiovascular risk factors: hypertension (71%), dyslipidemia (71%), obesity (34%) and diabetes (31%). A history of smoking was present in 66% of patients, although only one patient was still an active smoker at baseline. Acute coronary syndrome was the most frequent indication for referral (68.6%), followed by post-surgical valvular repair (17.1%) and stable coronary artery disease (11.4%). After CR, exercise duration increased by approximately one minute (p=0.001), and estimated functional capacity improved from 10.4±3.4 to 11.7±3.4 METS (mean change +1.21±1.49; p<0.001). In the subgroup with six-minute walk test data, distance increased by 74±51 meters (p=0.005). Significant improvements in lipid profile were observed: LDL decreased by 20.4 mg/dL (p=0.031), HDL increased by 5.8 mg/dL (p=0.012) and triglycerides decreased by 35.5 mg/dL (p=0.047). Total cholesterol showed a non-significant downward trend (p=0.059).
Conclusions
A 12-week center-based structured CR program was associated with meaningful improvements in exercise tolerance and metabolic risk control. These findings demonstrate the positive impact of CR in supporting functional recovery and risk reduction, underscoring its relevance as an integrated component of cardiovascular secondary prevention.