Key result
Obese patients undergoing cardiac rehabilitation achieved comparable improvements in exercise capacity to non-obese patients, with no significant difference in the change in metabolic equivalents (Hedges' g 0.043).
Why the study?
Although cardiac rehabilitation is effective after cardiac events and surgeries, whether baseline body mass index impacts rehabilitation outcomes remained unclear.
Does baseline BMI impact improvements in exercise capacity and lipid profile in patients undergoing cardiac rehabilitation?
Meta-Analysis (n=12,000)
Does baseline BMI impact improvements in exercise capacity and lipid profile in patients undergoing cardiac rehabilitation?
Pre-rehabilitation BMI does not significantly affect improvements in exercise capacity and lipid profile in patients undergoing cardiac rehabilitation.
Answers are grounded in this paper and cite their sources.
Obese patients derive similar exercise capacity gains from cardiac rehabilitation as non-obese; high heterogeneity leaves optimal BMI-tailored programs open for prospective trials.
Objective The effectiveness of cardiac rehabilitation (CR) after cardiac events and surgeries is well known. However, whether baseline body mass index (BMI) impacts CR outcomes is unclear. This first systematic review and meta-analysis of literature examined the difference in CR outcomes based on various BMI categories. Methods The Web of Science, Embase, PubMed, and Scopus databases were searched until October 6, 2025, for all studies examining the outcomes of CR based on BMI. The primary outcome was the change in exercise capacity [as measured by changes in metabolic equivalents (METs)]. In contrast, secondary outcomes included changes in BMI, lipid profile, resting heart rate, and resting blood pressure. Results Eighteen studies were included. In the comparison of obese vs. non-obese participants, pooled results showed no significant difference in the change in METs between the two groups. Subgroup analyses based on study design and obesity definition did not alter the overall findings. Among secondary outcomes, the change in BMI was not significantly different between the groups. Additionally, total cholesterol levels improved slightly more in non-obese individuals; however, there were no significant differences observed for high-density lipoprotein (HDL), triglycerides, heart rate, or blood pressure. In the comparison of overweight vs. normal BMI groups, no significant differences were observed for change in METs or BMI. Similarly, total cholesterol and HDL levels did not differ significantly between groups, although triglyceride reduction was greater among patients with a normal BMI. High heterogeneity was noted in most analyses. Conclusions Our results indicate that pre-rehabilitation BMI does not affect improvements in exercise capacity and lipid profile in CR patients. Variations in CR protocols and high inter-study heterogeneity prohibit firm conclusions. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251153489 , identifier CRD420251153489.
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Tu et al. (2026) conducted a meta-analysis in Cardiac rehabilitation after cardiac events and surgeries (n=12,000). Cardiac rehabilitation in obese patients vs. Cardiac rehabilitation in non-obese patients was evaluated on Change in exercise capacity (metabolic equivalents [METs]) (Hedges' g 0.043, 95% CI -0.223 to 0.308, p=0.751). Obese patients undergoing cardiac rehabilitation achieved comparable improvements in exercise capacity to non-obese patients, with no significant difference in the change in metabolic equivalents (Hedges' g 0.043).
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