The effects of exercise training on low-density lipoprotein mediated blood flow in coronary artery disease: a systematic review

Abstract

Regular exercise reduces the risk factors for cardiovascular disease (CVD). In recent years, interventions have been developed to prevent coronary artery disease (CAD). Elevated low- density lipoproteins (LDL) contribute to the development of atherosclerosis by constricting the endothelium and impairing the endothelial function of coronary arteries. For this reason, flow-mediated dilation (FMD) is used for assessment. Electronic databases were searched for exercise interventions performed over a period of ≥6 weeks that affected LDL levels and/or FMD in CAD patients and healthy subjects. Twenty randomized controlled trials met the eligibility criteria for this systematic review. Endurance training resulted in greater reductions in LDL levels and their subfractions and had significant effects on FMD (~P<0.0001). Other exercise interventions had various benefits, including improved physical fitness and quality of life. Participants who exercised supervised for ≥60 minutes/session, 3-4 times per week, at moderate to vigorous intensity showed significant FMD response and/or LDL improvement (P<0.05) compared to those with lower intensity, frequency, and duration (P>0.05). Exercise training (ET) might correlate positively with improved FMD, but the limited LDL evidence might not be significantly related to improved blood flow. The aim of this review is to determine the optimal exercise programme to prevent the progression of CAD. In conclusion, the relationship between ET, LDL levels, and FMD is complex but shows promise for secondary prevention of CAD.