Volume 17, Issue 2 (4-2020)
J Res Dev Nurs Midw 2020, 17(2): 11-14 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Zaersabet F, Salari A, Alizadeh I, Moaddab F, Rouhi Balasi L, Ashouri A. Physical Activity and Biochemical Parameters in Patients with Acute Coronary Syndrome: A Cross-Sectional Study. J Res Dev Nurs Midw 2020; 17 (2) :11-14
URL: http://nmj.goums.ac.ir/article-1-1200-en.html
URL: http://nmj.goums.ac.ir/article-1-1200-en.html
Fatemeh Zaersabet1 
, Arsalan Salari 2, Iman Alizadeh1 , Fatemeh Moaddab1 , Leila Rouhi Balasi1 , Asieh Ashouri1
, Arsalan Salari 2, Iman Alizadeh1 , Fatemeh Moaddab1 , Leila Rouhi Balasi1 , Asieh Ashouri1
1- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
2- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran , asalari828@gmail.com
2- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran , asalari828@gmail.com
Keywords: Acute Coronary Syndrome [MeSH], Exercise [MeSH], Biomarkers [MeSH], Cardiovascular Failure
Full-Text [PDF 633 kb]
(902 Downloads)
| Abstract (HTML) (2977 Views)
Full-Text: (747 Views)
Abstract
Background: Physical activity reduces the risk of Coronary Heart Disease (CHD). The precise mechanism for reducing CHD risk after physical activity has not been determined. The aim of this study was to determine the relationship between physical activity and some biochemical parameters in patients with Acute Coronary Syndrome (ACS).
Methods: This cross-sectional study was conducted on patients with ACS referring to Heshmat Medical Center in 2016. Convenient sampling method was used and 280 eligible patients with ACS were included in the study. For data gathering the checklist was used for demographic characteristics of patients and biochemical parameters and the Baecke Questionnaire was used to assess the patients’ physical activity. The data were analyzed in PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc. using Spearman correlation and multiple regression analyses. The significance level was set at P>0.05.
Results: The results showed that 67% of the patients were male and the mean age of the patients was 62.38±12.01 years. The BUN blood urea nitrogen (r=-.121 and -.177) and blood creatinine level (r=-.259 and -.185) had a significant correlation with physical activity in general and at the work hours, (P<.05). However, these correlations were poor, and only the correlation between the creatinine level and physical activity at work was moderate.
Conclusions: The correlation between physical activity level and biochemical parameters was not observed in our study. However, because the protective effect of physical activity on the cardiovascular system is clearly observed, it is suggested that appropriate physical activity and regular fitness be incorporated in the care plan for patients with cardiovascular diseases. Further clinical studies are recommended.
Keywords: Acute Coronary Syndrome, Physical Activity, Biomarkers, Cardiovascular Failure
10.29252/jgbfnm.17.2.27
Methods: This cross-sectional study was conducted on patients with ACS referring to Heshmat Medical Center in 2016. Convenient sampling method was used and 280 eligible patients with ACS were included in the study. For data gathering the checklist was used for demographic characteristics of patients and biochemical parameters and the Baecke Questionnaire was used to assess the patients’ physical activity. The data were analyzed in PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc. using Spearman correlation and multiple regression analyses. The significance level was set at P>0.05.
Results: The results showed that 67% of the patients were male and the mean age of the patients was 62.38±12.01 years. The BUN blood urea nitrogen (r=-.121 and -.177) and blood creatinine level (r=-.259 and -.185) had a significant correlation with physical activity in general and at the work hours, (P<.05). However, these correlations were poor, and only the correlation between the creatinine level and physical activity at work was moderate.
Conclusions: The correlation between physical activity level and biochemical parameters was not observed in our study. However, because the protective effect of physical activity on the cardiovascular system is clearly observed, it is suggested that appropriate physical activity and regular fitness be incorporated in the care plan for patients with cardiovascular diseases. Further clinical studies are recommended.
Keywords: Acute Coronary Syndrome, Physical Activity, Biomarkers, Cardiovascular Failure
10.29252/jgbfnm.17.2.27
Introduction
Cardiovascular diseases, including the coronary artery disease, are viewed as one of the main causes of death in the world (1, 2); and the leading cause of premature deaths and disability in developed countries (3). Cardiovascular diseases have also turned into a social problem in Iran (4). Normally, acute coronary syndrome occurs in individuals over 45; however, the prevalence of such factors as obesity, hypertension, diabetes and metabolic syndromes have increased the risk of premature cardiovascular disease in the young (5). Acute coronary syndrome refers to a group of clinical symptoms including acute myocardial ischemia and a spectrum of clinical conditions like unstable angina, Non-ST Segment Elevation Myocardial Infarction (NSTEMI) and ST Segment Elevation Myocardial Infarction (STEMI) (6).
Research has shown that physical activity reduces the risk of coronary diseases and inactive people are more susceptible to developing cardiovascular diseases (7). Therefore, doing physical activities are regarded as one of the non-drug treatments and beneficial mechanisms to prevent and fix the level of risk factors of cardiovascular diseases (7, 8). Regular physical activity reduces the probability of the occurrence of health threatening situations including mortality risk and the complications of chronic diseases like cardiovascular diseases (9, 10).
The results of a study by Held et al (2011) showed that the risk of cardiac diseases was low in a group of employees who had a marginal to average physical activity and had lighter workload, whereas drivers and those who used to watch TV a lot had a higher risk of developing myocardial infarction (11). In addition, the results of a study by Etemad and Esmail Nasab on a group of students showed that there was a significant correlation between physical activity and the percentage of body fat, body fat mass and the level of cholesterol of male and female students (7). According to the results of a study conducted in 2002, regular physical activity is a practical strategy to prevent cardiovascular disease particularly myocardial infarction and to rehabilitate individuals afflicted by such disease. It has also been reported that the incidence of cardiovascular disease in a period of two years was less than one percent in individuals with average physical activity and was 3.2 percent in people with low physical activity. It was actually shown that there was an indirect correlation between the amount of weekly physical activity and the mortality rate resulting from cardiovascular diseases(12) .
The results of a study by Florind et al showed that there was a significant correlation between the level of physical activity and age, gender and body mass index (13).Therefore, one of the major challenges of heart rehabilitation program is changing lifestyle and incorporating physical activities in individuals’ daily routines (14) .
Several lines of evidence suggest that there is a reverse relationship between the level of physical activity and complications of cardiovascular disease. A study by Takashima et al (2004) on physical activity has shown contradictory results (8, 15). Despite sample evidence confirming that physical activity reduces the risk of developing Coronary Heart Disease (CHD), the exact mechanism for the reduction of CHD risk following physical activity has not been identified yet. It is, however, speculated that such a reduction occurs because of curbing risk factors like reduced LDL-C and triglyceride level as well as higher HDL-C level (11) . In a study on hemodialysis patients, Matsuzawa et al showed that physical activity is related to HDL-C and that low level of physical activity has a strong correlation with the reduction of HDL-C in patients (16). Skretteberg et al (2012) showed that there is a significant correlation between higher HDL level and lower risk of cardiovascular disease, whereas there is no significant correlation between HDL and physical activity (17). Aadahl et al (2007) conducted a study in Denmark showing that there is an indirect significant correlation between an average level of less than 45 minutes of physical activity in 24 hours and waist circumference size, body mass index and triglyceride. There was also a positive correlation with HDL. Moreover, there was no significant correlation in people with the physical activity over 45 minutes in 24 hours (18). The results of a study by Stewart et al (2013) indicated that 46 percent of the patients with coronary heart disease had a lower physical activity compared with the time before being diagnosed with heart disease (19). Such findings necessitate a lifestyle change to eliminate contributory factors in coronary heart disease. Given the fact that inadequate physical activity increases risk factors of coronary heart diseases (20), the present study was designed to investigate the association between physical activity and the results of some biochemical parameters in blood of the patients with acute coronary syndrome.
Research has shown that physical activity reduces the risk of coronary diseases and inactive people are more susceptible to developing cardiovascular diseases (7). Therefore, doing physical activities are regarded as one of the non-drug treatments and beneficial mechanisms to prevent and fix the level of risk factors of cardiovascular diseases (7, 8). Regular physical activity reduces the probability of the occurrence of health threatening situations including mortality risk and the complications of chronic diseases like cardiovascular diseases (9, 10).
The results of a study by Held et al (2011) showed that the risk of cardiac diseases was low in a group of employees who had a marginal to average physical activity and had lighter workload, whereas drivers and those who used to watch TV a lot had a higher risk of developing myocardial infarction (11). In addition, the results of a study by Etemad and Esmail Nasab on a group of students showed that there was a significant correlation between physical activity and the percentage of body fat, body fat mass and the level of cholesterol of male and female students (7). According to the results of a study conducted in 2002, regular physical activity is a practical strategy to prevent cardiovascular disease particularly myocardial infarction and to rehabilitate individuals afflicted by such disease. It has also been reported that the incidence of cardiovascular disease in a period of two years was less than one percent in individuals with average physical activity and was 3.2 percent in people with low physical activity. It was actually shown that there was an indirect correlation between the amount of weekly physical activity and the mortality rate resulting from cardiovascular diseases(12) .
The results of a study by Florind et al showed that there was a significant correlation between the level of physical activity and age, gender and body mass index (13).Therefore, one of the major challenges of heart rehabilitation program is changing lifestyle and incorporating physical activities in individuals’ daily routines (14) .
Several lines of evidence suggest that there is a reverse relationship between the level of physical activity and complications of cardiovascular disease. A study by Takashima et al (2004) on physical activity has shown contradictory results (8, 15). Despite sample evidence confirming that physical activity reduces the risk of developing Coronary Heart Disease (CHD), the exact mechanism for the reduction of CHD risk following physical activity has not been identified yet. It is, however, speculated that such a reduction occurs because of curbing risk factors like reduced LDL-C and triglyceride level as well as higher HDL-C level (11) . In a study on hemodialysis patients, Matsuzawa et al showed that physical activity is related to HDL-C and that low level of physical activity has a strong correlation with the reduction of HDL-C in patients (16). Skretteberg et al (2012) showed that there is a significant correlation between higher HDL level and lower risk of cardiovascular disease, whereas there is no significant correlation between HDL and physical activity (17). Aadahl et al (2007) conducted a study in Denmark showing that there is an indirect significant correlation between an average level of less than 45 minutes of physical activity in 24 hours and waist circumference size, body mass index and triglyceride. There was also a positive correlation with HDL. Moreover, there was no significant correlation in people with the physical activity over 45 minutes in 24 hours (18). The results of a study by Stewart et al (2013) indicated that 46 percent of the patients with coronary heart disease had a lower physical activity compared with the time before being diagnosed with heart disease (19). Such findings necessitate a lifestyle change to eliminate contributory factors in coronary heart disease. Given the fact that inadequate physical activity increases risk factors of coronary heart diseases (20), the present study was designed to investigate the association between physical activity and the results of some biochemical parameters in blood of the patients with acute coronary syndrome.
Methods
This cross sectional study was done on patients with acute coronary syndrome referring to a heart center in Rasht in the north of Iran in 2015. The sample size was calculated using the correlation sample size formula
with a significance level of 0.05, a statistical power of 0.80 and a correlation of 0.18 based on a study by Matsuzawa et al (16). After considering 15% of the total sample size for the probable missing data, the required sample size was determined as at least 278 patients. The convenience sampling method was used and 282 eligible patients with acute coronary syndrome were recruited in the study (20). The inclusion criteria for the patients were having acute coronary syndrome and being willing to participate in the research. The patients who had elevated high sensitivity C-reactive protein (CRP) levels and took anti-inflammatory drugs were excluded from the study. Data were collected using the checklist for demographic characteristics of patients, biochemical parameters and the Baecke Questionnaire.
The demographic characteristics of patients were included age, gender, marital status, education level, life status, occupation, residence area, family history of heart disease and diabetes or hypertension and body mass index. The biochemical parameters were included of the patients’ laboratory tests in the first 24 to 48 hours of being admitted to the hospital (including Feritin-HbA1c-FBS-BUN-Cr-LDL-HDL–TG-CHOL) which was available in the medical record of patients.
To collect the data, first, the personal characteristics of the participants were recorded and then their weight and height were measured. Calibration of the weighing scales was performed and to ensure accurate measurements, the patients’ weight was measured with Seca (made in Iran). The patients were asked to remove excess clothes and shoes before measuring their weight. A meter was used for measuring the patients’ height with a precision of half a centimeter and the patients’ height was measured with the participants standing against a wall and their heels and buttocks in contact with the wall. Next, blood specimens were taken from the participants anonymously in the same environment and at the same time. The body mass index was calculated on the basis of dividing weight (kilogram) by the square of height (meter) and the values less than 18.5 were considered as thin, over 18.5 and less than 25 were listed as normal, equal to or over 25 were labeled as overweight and over or equal to 30 were named as obese (22). The patients’ physical activity was assessed using the Backed questionnaire which is a reliable and valid instrument (13, 21). The questionnaire comprises three dimensions; physical activity at work, physical activity at exercise time and exercise at the leisure time, and the participants’ performance over the past month. The questionnaire consisted of 16 items, eight items were on physical activity at work time and four items were on physical activity at sport time and the last four items were on physical activity at the leisure time. The scores were calculated using a predefined algorithm (20). The scores ranged from 1 to 5 for each of the three dimensions and 3 to 15 in total. A higher score shows a higher level of activity. In addition, an acceptable level of intra-class correlation coefficient was reported for the Persian version of the questionnaire (with ICC of work score=0.95, sport score=0.93, and leisure score=0.77) (23).
Informed consent was obtained from all patients before they take part in the study. The study was approved by Guilan University of Medical Sciences and received an ethical approval code of IR.GUMS.REC.1394.243 from the university’s Ethics Committee.
The descriptive statistics (mean, standard deviation, and frequency) were used to present the results. Spearman corrwas used to test the correlation between the quantitative variables and physical activity. Multivariable regression analysis was used to confirm the relation between BUN and Cr levels and physical activity after adjusting for the confounders. The data were analyzed in PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.. The significant level was considered less than 0.05.
with a significance level of 0.05, a statistical power of 0.80 and a correlation of 0.18 based on a study by Matsuzawa et al (16). After considering 15% of the total sample size for the probable missing data, the required sample size was determined as at least 278 patients. The convenience sampling method was used and 282 eligible patients with acute coronary syndrome were recruited in the study (20). The inclusion criteria for the patients were having acute coronary syndrome and being willing to participate in the research. The patients who had elevated high sensitivity C-reactive protein (CRP) levels and took anti-inflammatory drugs were excluded from the study. Data were collected using the checklist for demographic characteristics of patients, biochemical parameters and the Baecke Questionnaire.
The demographic characteristics of patients were included age, gender, marital status, education level, life status, occupation, residence area, family history of heart disease and diabetes or hypertension and body mass index. The biochemical parameters were included of the patients’ laboratory tests in the first 24 to 48 hours of being admitted to the hospital (including Feritin-HbA1c-FBS-BUN-Cr-LDL-HDL–TG-CHOL) which was available in the medical record of patients.
To collect the data, first, the personal characteristics of the participants were recorded and then their weight and height were measured. Calibration of the weighing scales was performed and to ensure accurate measurements, the patients’ weight was measured with Seca (made in Iran). The patients were asked to remove excess clothes and shoes before measuring their weight. A meter was used for measuring the patients’ height with a precision of half a centimeter and the patients’ height was measured with the participants standing against a wall and their heels and buttocks in contact with the wall. Next, blood specimens were taken from the participants anonymously in the same environment and at the same time. The body mass index was calculated on the basis of dividing weight (kilogram) by the square of height (meter) and the values less than 18.5 were considered as thin, over 18.5 and less than 25 were listed as normal, equal to or over 25 were labeled as overweight and over or equal to 30 were named as obese (22). The patients’ physical activity was assessed using the Backed questionnaire which is a reliable and valid instrument (13, 21). The questionnaire comprises three dimensions; physical activity at work, physical activity at exercise time and exercise at the leisure time, and the participants’ performance over the past month. The questionnaire consisted of 16 items, eight items were on physical activity at work time and four items were on physical activity at sport time and the last four items were on physical activity at the leisure time. The scores were calculated using a predefined algorithm (20). The scores ranged from 1 to 5 for each of the three dimensions and 3 to 15 in total. A higher score shows a higher level of activity. In addition, an acceptable level of intra-class correlation coefficient was reported for the Persian version of the questionnaire (with ICC of work score=0.95, sport score=0.93, and leisure score=0.77) (23).
Informed consent was obtained from all patients before they take part in the study. The study was approved by Guilan University of Medical Sciences and received an ethical approval code of IR.GUMS.REC.1394.243 from the university’s Ethics Committee.
The descriptive statistics (mean, standard deviation, and frequency) were used to present the results. Spearman corrwas used to test the correlation between the quantitative variables and physical activity. Multivariable regression analysis was used to confirm the relation between BUN and Cr levels and physical activity after adjusting for the confounders. The data were analyzed in PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.. The significant level was considered less than 0.05.
Methods
The finding showed that 67% of the participants were male and the average age of the patients was 62.38±12.01 years old, which ranged from 33 to 91 (Table 1). Physical activity scores in total and in each of the investigated areas are given in Table 2 and a description of the biochemical parameters investigated in the study is given in Table 3. Except for the work hours, the patients' physical activity was low in all dimensions (Table 2).
The findings indicated that only the BUN (r=-.121 and -.177) and blood creatinine level (r=-.259 and -.185) had a significant negative correlation with the level of physical activity in total and at the work hours, respectively. However, the severity of these correlations was poor, and there was only a negative correlation with moderate severity between the creatinine level and physical activity at work (Table 4). The results of the correlation between biochemical parameters and demographic characteristics also showed that the level of BUN and Cr was significantly higher in elder patients (r=.294, P<0.001 and r=.336, P<0.001 for BUN and Cr respectively) and that there was no significant correlation between other variables (gender, education, place of residence and BMI category) and the level biochemical parameters (p>0.05 for all).
Moreover, as the findings showed that the BUN had a significant correlation with age, a multiple regression was used to control the effect of age.
In the regression analysis, the results showed that controlling for the effect of age, there was no significant relationship between the BUN parameter and the level of physical activity in general and during the work, sport and free time. There was also no significant relationship between the Cr parameter and the physical activity in general (P=0.181), during sport activities and in the free time. There was, however, a negative significant correlation between the physical activity at work and the level of Cr (b=-.277, 95% CI: -.477 to -.081, p=0.006).
The findings indicated that only the BUN (r=-.121 and -.177) and blood creatinine level (r=-.259 and -.185) had a significant negative correlation with the level of physical activity in total and at the work hours, respectively. However, the severity of these correlations was poor, and there was only a negative correlation with moderate severity between the creatinine level and physical activity at work (Table 4). The results of the correlation between biochemical parameters and demographic characteristics also showed that the level of BUN and Cr was significantly higher in elder patients (r=.294, P<0.001 and r=.336, P<0.001 for BUN and Cr respectively) and that there was no significant correlation between other variables (gender, education, place of residence and BMI category) and the level biochemical parameters (p>0.05 for all).
Moreover, as the findings showed that the BUN had a significant correlation with age, a multiple regression was used to control the effect of age.
In the regression analysis, the results showed that controlling for the effect of age, there was no significant relationship between the BUN parameter and the level of physical activity in general and during the work, sport and free time. There was also no significant relationship between the Cr parameter and the physical activity in general (P=0.181), during sport activities and in the free time. There was, however, a negative significant correlation between the physical activity at work and the level of Cr (b=-.277, 95% CI: -.477 to -.081, p=0.006).
|
Table 1. The frequency of patients’ demographic characteristics
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Table 2. The scores of physical activity and its domains
* Inter-Quartile Range
|
|
Table 3. Description of biochemical parameters of patients
Chol, cholesterol; HbA1C, hemoglobin glycosylated; BUN, blood urea nitrogen; CR, creatinine; FBS, fasting blood sugar; TG, triglyceride; LDL, low-density lipoprotein; HDL, high-density lipoprotein.
|
|
Table 4. Correlation between biochemical parameters and physical activity domains
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Discussion
Cardiovascular disease in the recent decade has been the main cause of mortality in industrial countries. It seems that physical activity can perform a significant role in decreasing the incidence and progression of cardiovascular diseases through having an effect on total cholesterol, HDL, LDL and TG (7). The present study was conducted to determine the relationship between the level of physical activity and biochemical parameters of the blood in patients with acute coronary syndrome. The findings of the study demonstrated that except for the creatinine level of blood, no other measured biochemical parameter (HDL, LDL, TG, Feritin, FBS, HBA1C and BUN) had a significant correlation with the level of physical activity. Unlike the findings of the present study, a study by Matsuzawa demonstrated a significant correlation between HDL and level of physical activity (16). Rahmani et al also reported that there exists a significant correlation between the level of physical activity and cholesterol, TG, LDL and HDL (20). Aadahl et al also investigated the correlation between the level of physical activity and cardiovascular risk factors in an adult population, reporting that there is a significant correlation between physical activity and TG and HDL (18) . The findings of a study by Hosseini et al also indicated that there exists a significant correlation between physical activity and LDL and total cholesterol; the results of their study , however, did not show a relationship between physical activity and HDL (20). Additionally, a study by Etemad et al showed that there is a significant correlation between students' physical activity and cholesterol and LDL, but there is no correlation between physical activity and TG and HDL (7). In the same vein, Bijeh et al studied the effect of a six-month training course on lung function markers of middle-aged women, reporting no remarkable correlation between the levels of BUN, Creatinine and GFR (21).
The researchers believe that the existing differences and disagreements in the findings of the studies could be due to the differences in the population of the studies and differences in the age and gender groups studied. Additionally, as each of the studies in this area have been carried out in different parts of the country and the world, it can be claimed that part of the differences in the findings of the studies could be owing to cultural and climatic differences. If other variables such as lifestyle, nutrition, were investigated as intervening variables in the statistical analyses, other results could be obtained.
Although the present study demonstrated no significant correlation between physical activity and biochemical parameters of blood, given the advice of ACSM, CDC, and surgeons (22), daily exercise is highly recommended because of its protective effect on the heart as well as people’s general health. The results also indicated no significant relationship between physical activity and HDL and it had been reported that this might be due to the lack of intense and regular physical activity by subjects (23).
With regard to the findings of the present study, it is suggested that a more comprehensive study with a larger sample size be conducted.
One of the limitations of the present study could be the sample size under investigation; the results could be much better if the study were conducted on a larger sample size. As a correlation existed between level of physical activity and patients' lung function markers (BUN and Cr), it is suggested that a similar study be conducted on patients with lung dysfunction. It is also advised that appropriate levels of suitable physical activities, with regard to their dehydration effects, be included in the treatment and protective programs. In addition, with regard to the results of this study and because of the lack of a relationship between physical activity and biochemical parameters, physical activity should be considered in the treatment of patients with acute coronary syndrome.
Conclusion
Although the findings of the study indicated no significant correlation between physical activity and parameters such as HDL, LDL, and TG, as the protective effect of physical activity on cardiovascular system has been proved, it is recommended that regular and proper physical activity be incorporated in the treatment and care program of the patients with chronic diseases particularly cardiovascular ones. Moreover, with regard to the role of education in the reduction of dire consequences of chronic diseases in the society and treatment systems, it is suggested that training courses and workshops on the positive effects of physical activities and the right ways of doing them be organized.
Acknowledgment
This study is based on a research approved by the deputy of research and technology (No. 94052739) and Ethics Committee of Guilan University of Medical Sciences (Code: IR.GUMS.REC.1394.243). Hereby, the authors would like to appreciate the vice-chancellor for research and technologyfor financial support, the head and staff of Dr. Heshmat Hospital and all patients who participated in this study.
The researchers believe that the existing differences and disagreements in the findings of the studies could be due to the differences in the population of the studies and differences in the age and gender groups studied. Additionally, as each of the studies in this area have been carried out in different parts of the country and the world, it can be claimed that part of the differences in the findings of the studies could be owing to cultural and climatic differences. If other variables such as lifestyle, nutrition, were investigated as intervening variables in the statistical analyses, other results could be obtained.
Although the present study demonstrated no significant correlation between physical activity and biochemical parameters of blood, given the advice of ACSM, CDC, and surgeons (22), daily exercise is highly recommended because of its protective effect on the heart as well as people’s general health. The results also indicated no significant relationship between physical activity and HDL and it had been reported that this might be due to the lack of intense and regular physical activity by subjects (23).
With regard to the findings of the present study, it is suggested that a more comprehensive study with a larger sample size be conducted.
One of the limitations of the present study could be the sample size under investigation; the results could be much better if the study were conducted on a larger sample size. As a correlation existed between level of physical activity and patients' lung function markers (BUN and Cr), it is suggested that a similar study be conducted on patients with lung dysfunction. It is also advised that appropriate levels of suitable physical activities, with regard to their dehydration effects, be included in the treatment and protective programs. In addition, with regard to the results of this study and because of the lack of a relationship between physical activity and biochemical parameters, physical activity should be considered in the treatment of patients with acute coronary syndrome.
Conclusion
Although the findings of the study indicated no significant correlation between physical activity and parameters such as HDL, LDL, and TG, as the protective effect of physical activity on cardiovascular system has been proved, it is recommended that regular and proper physical activity be incorporated in the treatment and care program of the patients with chronic diseases particularly cardiovascular ones. Moreover, with regard to the role of education in the reduction of dire consequences of chronic diseases in the society and treatment systems, it is suggested that training courses and workshops on the positive effects of physical activities and the right ways of doing them be organized.
Acknowledgment
This study is based on a research approved by the deputy of research and technology (No. 94052739) and Ethics Committee of Guilan University of Medical Sciences (Code: IR.GUMS.REC.1394.243). Hereby, the authors would like to appreciate the vice-chancellor for research and technologyfor financial support, the head and staff of Dr. Heshmat Hospital and all patients who participated in this study.
Type of Study: Original Article |
Subject:
Psychology and Psychiatry
References
1. 1. Masoumi M, Saeidi MR, Piri F, Abdoli GR. Epidemiological evaluation of coronary artery disease (CAD) in Patients referred to cardiovascular centers of Kermanshah (2001-2002). J Kermanshah Univ Med Sci. 2004; 8(2): 37-49. [Persian] [View at paplisher] [Google Scholar]
2. Shakeri J, Jaberghaderi N, Rezaei M, Saeedi M, Naleini M, Moloodi A. Psychosocial risk factors in patients with cardio-vascular diseases in Kermanshah (2006). J Kermanshah Univ Med Sci. 2012; 16(3):246-54. [Persian] [View at paplisher] [Google Scholar]
3. Keyvanara M, Sadeghi M, Saghaeiannejad Isfahani S, Tadayon H. A comparative review of national registry systems of acute coronary syndrome in selective countries. Health Inf Manage. 2012; 9(2); 172-9. [Persian] [View at paplisher] [Google Scholar]
4. Khodadadi A, Sayadi A, Smaeli H. Evolution of Knowledge of the principles of self-care in acute coronary syndrome patients admitted to Aliebn Abitaleb Rafsanjan university hospital during 2009. Community Health Journal. 2017; 5(1):8-16. [Persian] [View at paplisher] [Google Scholar]
5. Taghipour B, SHarif NH, Soleimani MA, Hekmat AM, SHahidi FS. Comparison of the clinical symptoms of myocardial infarction in the middle-aged and elderly. J Kermanshah Univ Med Sci. 2014; 18(5):281-9. [Persian] [View at paplisher] [Google Scholar]
6. Kumar A, Cannon CP. Acute coronary syndromes: diagnosis and management, part I. Mayo Clin Proc. 2009: 84(10). 917-938. [View at paplisher] [DOI] [Google Scholar]
7. Etemad Z, Esmailnasab N. The relationship between the level of physical activity and some risk factors of coronary heart disease in the university students. SJKU. 2012; 17 (1):25-35. [persian] [View at paplisher] [Google Scholar]
8. Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000; 343(1):16-22. [View at paplisher] [DOI]
9. De Oliveira EP, Moreto F, de Arruda Silveira LV, Burini RC. Dietary, anthropometric, and biochemical determinants of uric acid in free-living adults. Nutrition. 2013; 12(1):11. [View at paplisher] [DOI] [Google Scholar]
10. Knox EC, Esliger DW, Biddle SJ, Sherar LB. Lack of knowledge of physical activity guidelines: can physical activity promotion campaigns do better? BMJ open. 2013 1; 3(12):e003633. [View at paplisher] [DOI] [Google Scholar]
11. Held C, Iqbal R, Lear SA, Rosengren A, Islam S, Mathew J, et al. Physical activity levels, ownership of goods promoting sedentary behaviour and risk of myocardial infarction: results of the inter heart study. Eur Heart J. 2012; 33(4):452-66. [View at paplisher] [DOI] [Google Scholar]
12. Haennel RG, Lemire F. Physical activity to prevent cardiovascular disease. How much is enough? Can Fam Physician. 2002; 48(1):65-71. [View at paplisher] [Google Scholar]
13. Florindo AA, Latorre MD. Validation and reliability of the Baecke questionnaire for the evaluation of habitual physical activity in adult men. Revista Brasileira de Medicina do Esporte. 2003; 9(3):129-35. [View at paplisher] [DOI] [Google Scholar]
14. Guiraud T, Granger R, Gremeaux V, Bousquet M, Richard L, Soukarié L, et al. Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program. Arch Phys Med Rehabil. 2012; 93(12):2141-7. [View at paplisher] [DOI]
15. Takeshima N, Rogers ME, Islam MM, Yamauchi T, Watanabe E, Okada A. Effect of concurrent aerobic and resistance circuit exercise training on fitness in older adults. Eur J Appl Physiol. 2004; 93(1-2):173-82. [View at paplisher] [DOI] [Google Scholar]
16. Matsuzawa R, Matsunaga A, Kutsuna T, Ishii A, Abe Y, Yoneki K, et al. Association of habitual physical activity measured by an accelerometer with high-density lipoprotein cholesterol levels in maintenance hemodialysis patients. Scientific World Journal. 2013; 2013. [View at paplisher] [DOI] [Google Scholar]
17. Skretteberg PT, Grundvold I, Kjeldsen SE, Erikssen JE, Sandvik L, Liestol K, et al. HDL-cholesterol and prediction of coronary heart disease: Modified by physical fitness?: A 28-year follow-up of apparently healthy men. Atherosclerosis. 2012; 220(1):250-6. [View at paplisher] [DOI] [Google Scholar]
18. Aadahl M, Kjær M, Jørgensen T. Associations between overall physical activity level and cardiovascular risk factors in an adult population. Eur J Epidemiol. 2007; 22(6):369-78. [View at paplisher] [DOI] [Google Scholar]
19. Stewart R, Held C, Brown R, Vedin O, Hagstrom E, Lonn E, et al. Physical activity in patients with stable coronary heart disease: an international perspective. Eur Heart J. 2013; 34(42):3286-93. [View at paplisher] [DOI] [Google Scholar]
20. Rahmani Ghobadi M, hoseini R. The Relationship of Physical Activity and Risk Factors of Coronary Heart Disease (CHD) in Older Men. Salmand: Iranian Journal of Ageing. 2015; 9 (4):316-323. [Persian] [View at paplisher] [Google Scholar]
21. Bijeh N, Farahati S. The effect of six months of aerobic training on renal function markers in untrained middle-aged women. IJSSH. 2013; 3(2):218-224. [View at paplisher] [Google Scholar]
22. Foran SE, Lewandrowski KB, Kratz A. Effects of exercise on laboratory test results. Laboratory Medicine. 2003; 10(34):736-42. [View at paplisher] [DOI] [Google Scholar]
23. Alijani E. Investigating the effect of weekly aerobic and nonaerobic exercises on cardiovascular risk factors in male students at Shahid Chamran University. Journal of Cardiovascular and Activeness .2001; 1:5-19. [Google Scholar]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
