ABSTRACT
Recent data indicate that the prevalence of obesity has progressively increased over the past two decades in the United States, and now nearly 50 million adult Americans are considered to be overweight (1, 2). Obesity is known to affect many of the well-known coronary artery disease (CAD) risk factors, increasing levels of systemic arterial pressure and the prevalence and severity of left ventricular hypertrophy (LVH), decreasing insulin sensitivity, adversely affecting plasma lipid profiles [particularly decreasing levels of the cardioprotective high-density lipoprotein (HDL) cholesterol and increasing triglycerides], and leading to a sedentary lifestyle (3-7). In addition to adversely affecting all these individual risk factors, data from both the Framingham Heart Study (8) and a large cohort of U.S. nurses (9) have indicated that obesity is an independent risk factor for major CAD events, particularly in women, and that it increases the risk for congestive heart failure from systolic and, in particular, diastolic, abnormalities (5, 6, 10). Previous data indicate that weight reduction from exercise training and/ or dietary caloric restriction reduces arterial pressure, LVH, and insulin resistance and improves plasma lipid profiles (11, 12). However, only very limited data are available on the impact of cardiac rehabilitation and exercise training programs in obese patients with CAD (2, 13).
