Key result
Comprehensive cardiac rehabilitation and aerobic training reduced systolic blood pressure by 6 to 14 mmHg and resting heart rate by 7 to 17 bpm in patients with cardiovascular disease in Sub-Saharan Africa.
Why the study?
Sub-Saharan Africa accounts for only 17% of globally available cardiac rehabilitation programs, prompting an evaluation of the benefits of employing any cardiac rehabilitation treatment modality in this resource-constrained region.
Do cardiac rehabilitation treatment modalities improve cardiovascular parameters, exercise capacity, and quality of life in patients with cardiovascular disease in Sub-Saharan Africa?
Systematic Review
Do cardiac rehabilitation treatment modalities improve cardiovascular parameters, exercise capacity, and quality of life in patients with cardiovascular disease in Sub-Saharan Africa?
Answers are grounded in this paper and cite their sources.
Cardiac rehabilitation, particularly exercise and comprehensive delivery, improves blood pressure, resting heart rate, and exercise capacity in patients with cardiovascular disease in Sub-Saharan Africa.
Purpose: Although Cardiac Rehabilitation (CR) implementation models recommend delivery of any CR treatment component, Sub-Saharan Africa (SSA) constitutes only 17% of globally available CR programs. The aims of this review were to assess the benefits of employing any CR treatment modality in SSA, and evaluate if this approach should be encouraged in this resource-constrained region. Methodology: Records were identified electronically via CINAHL, MEDLINE, Cochrane library, African journal online, PubMed, Web of science and google scholar, and grey literature was hand-searched. Articles reporting effectiveness of any CR treatment modality were included if participants had any cardiovascular disease and if the study was conducted in SSA. Quality assessment for each enrolled study was done using Downs and Black (1998) checklist and data was extracted using a modified standard tool. Results: Searches identified 1666 records, 24 full text articles were examined and 10 were included for the review; 60%, 30% and 10% of the enrolled studies were done in South Africa, Nigeria and Benin respectively. The studies implemented exercise, psychosocial and education treatment modalities of CR, and the approach of delivery was either comprehensive or modified. Comprehensive CR and delivery of combined aerobic and resistance exercises improved physical (13%, p=0.001), social (40%, p=0.001) and mental aspects of quality of life and reduced anxiety (-12%, p<0.05) and depression (-6%, p<0.001) respectively. Comprehensive CR and aerobic training both reduced systolic blood pressure (range of mean reduction [RMR] -6 to -14mmHg), diastolic blood pressure (RMR -4 to -6mmHg) and resting heart rate (RMR -7 to -17bpm). Overall, all types of exercises showed a 1-5ml.kg-1.min-1 increase in peak oxygen consumption. Conclusion: The findings support delivery of exercise treatment modality and comprehensive delivery of CR in SSA. However, efficacy of independent implementation of education and psychosocial therapeutic components of CR remains unclear; hence the need for further investigations.
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Namanja et al. (2021) conducted a systematic review in Cardiovascular disease. Cardiac rehabilitation vs. Usual care or no exercise was evaluated on Systolic blood pressure (RMR -6 to -14 mmHg). Comprehensive cardiac rehabilitation and aerobic training reduced systolic blood pressure by 6 to 14 mmHg and resting heart rate by 7 to 17 bpm in patients with cardiovascular disease in Sub-Saharan Africa.
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