Background Rheumatoid arthritis (RA) is known to be associated with increased cardiovascular (CV) disease due to classical risk factors and systemic inflammation (1). In the EULAR recommendations for CV risk management in patients with RA, exercise was defined as one of the pivotal factors that represented in the future research agenda (2). However, with regard to safety and effectivity, the intensity of exercise seems to be unclear in these patients.
Objectives In this randomized controlled study we aimed to evaluate the effects of an aerobic exercise intervention on CV risk factors and its safety in patients with RA.
Methods 40 patients with RA and age, gender, body mass index (BMI) and body composition matched 20 controls were included in our study. Patients were randomized into aerobic (performed on a treadmill while the heart rate was maintained at 60% of the age predicted maximum heart rate) or range of motion (ROM) exercise groups. Control group carried out the same aerobic exercise protocol. Both exercises frequency was five sessions per week for 2 weeks and the duration of the sessions were 20 minutes. Participants were assessed at baseline, at the 7th and 15thdays for RAcharacteristics (morning stiffness, pain –VAS-, erythrocyte sedimentation rate-ESR-, C-reactive protein -CRP-, Disease Activity Score 28 -DAS28- and Health Assessment Questionnaire –HAQ) and individual CV risk factors(blood pressure and lipids), 10-year CVD event probability.
Results The pain evaluation and DAS28 scores were improved significantly by the aerobic exercise treatment in RA patients (p < 0.001 and p<0.05, respectively) although no significant changes were observed on these parameters in ROM exercise group. There were no negative effect on morning stiffness duration, ESR and CRP levels in both patients groups. On the 15th day assessment, blood pressure (systolic-diastolic: p<0.05), lipids; triglycerides (p<0.05), high density lipoprotein (HDL; p<0.01), total cholesterol:HDL ratio (p<0.01), 10-year CVD event probability (p<0.05), were significantly improved both in healthy controls and in the aerobic exercise group versus the ROM exercise group in patients with RA.
Conclusions Our study suggests that short-term aerobic exercise intervention can lead to significantly positive effects on CV risk factors in patients with RA and with its well toleration, it supports that these patients are able to participate in this form of exercise without adverse effects on their condition.
Stavropoulos-Kalinoglou A, Metsios GS, Veldhuijzen van Zanten JJ, Nightingale P, Kitas GD, Koutedakis Y. Individualised aerobic and resistance exercise training improves cardiorespiratory fitness and reduces cardiovascular risk in patients with rheumatoid arthritis. Ann Rheum Dis. 2012 Nov 15.
Peters MJ, Symmons DP, McCarey D, Dijkmans BA, Nicola P, Kvien TK, McInnes IB, Haentzschel H, Gonzalez-Gay MA, Provan S, Semb A, Sidiropoulos P, Kitas G, Smulders YM, Soubrier M, Szekanecz Z, Sattar N, Nurmohamed MT. EULAR Ann Rheum Dis. 2010 Feb;69(2):325-31.
Disclosure of Interest None Declared