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IHD – Lowers risk factors eg Cholesterol, Diabetes, High blood pressure

Evidence summary (Updated 2022)
A large body of good quality randomised controlled data shows physical activity will have a positive effect on general health by reducing the prevalence of vascular risk factors of high cholesterol, diabetes and high blood pressure(1,2).
Gao et al, specifically look at yoga as an intervention compared to controls and found significant reductions in triglycerides and improvements in HDL cholesterol. In addition improvements in BMI were also noted and all constitute improved risk factors for CVD.(3)
When considering the intervention types while both HIIT and moderate intensity continuous training (MICT) reduced systolic and diastolic blood pressure, MICT was superior compared to HIIT (p<0.001, -3.61mmHg and -2.37mmHg respectively).(4) HIIT has also been shown to generally have better evidence supporting improvements in serum HDL (SMD=0.55, 95%CI 0.06 to 1.03, I2=0%) in patients after PCI (percutaneous coronary intervention) in a SR and MA of 6 RCTs of 247 patients.(5)

Quality of evidence
B- Moderate quality

Strength of recommendation
1- Strong

Conclusion
As per studies on general population physical activity is known to have a positive effect on general health and the impact on certain risk factors including high cholesterol & triglycerides, type 2 diabetes and high blood pressure , this is also supported by high quality evidence in IHD patients across a number of physical intervention types.

References

  1. Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med. 116:682–692.
  2. Hambrecht R, Walther C, Mobius-Winkler S, Gielen S, Linke A, Conradi K, et al. Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial. Circulation. 109(1371):1378.
  3. Li J, Gao X, Hao X, Kantas D, Mohamed EA, Zheng X, et al. Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis. Complement Ther Med [Internet]. 2021 Mar 1 [cited 2022 Oct 6];57. Available from: https://pubmed.ncbi.nlm.nih.gov/33338581/
  4. Du L, Zhang X, Chen K, Ren X, Chen S, He Q. Effect of high-intensity interval training on physical health in coronary artery disease patients: A meta-analysis of randomized controlled trials. J Cardiovasc Dev Dis [Internet]. 2021 Nov 1 [cited 2022 Oct 7];8(11). Available from: /pmc/articles/PMC8622669/
  5. Zhang X, Xu D, Sun G, Jiang Z, Tian J, Shan Q. Effects of high-intensity interval training in patients with coronary artery disease after percutaneous coronary intervention: A systematic review and meta-analysis. Nurs open [Internet]. 2021 May 1 [cited 2022 Oct 7];8(3):1424–35. Available from: https://pubmed.ncbi.nlm.nih.gov/33528117/

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