Skip to main content
Erschienen in: Rheumatology International 1/2024

31.10.2023 | Review

Exercise therapy for improving cardiovascular health in rheumatoid arthritis

verfasst von: Ilke Coskun Benlidayi

Erschienen in: Rheumatology International | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

There is increased risk of cardiovascular disease in patients with rheumatoid arthritis. Primary cardiovascular disease prevention in rheumatoid arthritis patients is difficult, especially in those with high disease activity. According to current evidence, people with rheumatoid arthritis can significantly improve clinical indices and patient-reported outcomes by engaging in organized physical activity such as resistance training and aerobic activities. Additionally, participating in an exercise regimen can lower the risk of experiencing cardiovascular problems. Nevertheless, the percentage of patients with sedentary lifestyle habits is high among individuals with rheumatoid arthritis. Patient education regarding the benefits of physical activity/exercise is essential. The cardiovascular effects of exercise depend on several mechanisms such as (i) increased vascular function, (ii) decreased systemic inflammation, (iii) restoration of the autonomic system, (iv) improved lipid profile, and (v) increased muscular function. Maintaining the exercise routine is crucial for continuing benefits. A customized exercise plan helps to improve adherence and compliance. Engaging patients in shared decision-making is important since their personal choices can alter depending on several factors such as the severity of the disease, the cost, and accessibility. The current narrative review aimed to explore the recent evidence related to exercise therapy for cardiovascular health in patients with rheumatoid arthritis.
Literatur
2.
Zurück zum Zitat Patel A, Bhatt V, Edara M (2022) A study of haematological profile in newly diagnosed rheumatoid arthritis and its correlation with disease activity. J Assoc Physicians India 70:11–12PubMed Patel A, Bhatt V, Edara M (2022) A study of haematological profile in newly diagnosed rheumatoid arthritis and its correlation with disease activity. J Assoc Physicians India 70:11–12PubMed
7.
Zurück zum Zitat Bonfiglioli KR, de Medeiros Ribeiro AC, Carnieletto AP, Pereira I, Domiciano DS, da Silva HC, Pugliesi A, Pereira LR, Guimarães MFR, Giorgi RDN, Reis APMG, Brenol CV, Louzada-Júnior P, da Cunha Sauma MFL, Radominski SC, da Mota LMH, da Rocha Castelar-Pinheiro G (2023) Extra-articular manifestations of rheumatoid arthritis remain a major challenge: data from a large, multi-centric cohort. Adv Rheumatol 63:34. https://doi.org/10.1186/s42358-023-00318-yCrossRefPubMed Bonfiglioli KR, de Medeiros Ribeiro AC, Carnieletto AP, Pereira I, Domiciano DS, da Silva HC, Pugliesi A, Pereira LR, Guimarães MFR, Giorgi RDN, Reis APMG, Brenol CV, Louzada-Júnior P, da Cunha Sauma MFL, Radominski SC, da Mota LMH, da Rocha Castelar-Pinheiro G (2023) Extra-articular manifestations of rheumatoid arthritis remain a major challenge: data from a large, multi-centric cohort. Adv Rheumatol 63:34. https://​doi.​org/​10.​1186/​s42358-023-00318-yCrossRefPubMed
9.
Zurück zum Zitat Heslinga M, Van Den Oever I, Jonker DL, Griep EN, Griep-Wentink H, Smulders YM, Lems WF, Boers M, Voskuyl AE, Peters M, Van Schaardenburg D, Nurmohamed MT (2019) Suboptimal cardiovascular risk management in rheumatoid arthritis patients despite an explicit cardiovascular risk screening programme. Scand J Rheumatol 48:345–352. https://doi.org/10.1080/03009742.2019.1600718CrossRefPubMed Heslinga M, Van Den Oever I, Jonker DL, Griep EN, Griep-Wentink H, Smulders YM, Lems WF, Boers M, Voskuyl AE, Peters M, Van Schaardenburg D, Nurmohamed MT (2019) Suboptimal cardiovascular risk management in rheumatoid arthritis patients despite an explicit cardiovascular risk screening programme. Scand J Rheumatol 48:345–352. https://​doi.​org/​10.​1080/​03009742.​2019.​1600718CrossRefPubMed
24.
Zurück zum Zitat Sobejana M, van den Hoek J, Metsios GS, Kitas GD, Jorstad HT, van der Leeden M, Pijnappels M, Lems WF, Nurmohamed MT, van der Esch M (2021) Cardiorespiratory fitness and physical activity in people who have rheumatoid arthritis at an increased risk of cardiovascular disease: a cross-sectional study. Rheumatol Int 41:2177–2183. https://doi.org/10.1007/s00296-021-04903-6CrossRefPubMed Sobejana M, van den Hoek J, Metsios GS, Kitas GD, Jorstad HT, van der Leeden M, Pijnappels M, Lems WF, Nurmohamed MT, van der Esch M (2021) Cardiorespiratory fitness and physical activity in people who have rheumatoid arthritis at an increased risk of cardiovascular disease: a cross-sectional study. Rheumatol Int 41:2177–2183. https://​doi.​org/​10.​1007/​s00296-021-04903-6CrossRefPubMed
25.
Zurück zum Zitat Sobejana M, van den Hoek J, Metsios GS, Kitas GD, van der Leeden M, Verberne S, Jorstad HT, Pijnappels M, Lems WF, Nurmohamed MT, van der Esch M (2022) Exercise intervention on cardiorespiratory fitness in rheumatoid arthritis patients with high cardiovascular disease risk: a single-arm pilot study. Clin Rheumatol 41:3725–3734. https://doi.org/10.1007/s10067-022-06343-4CrossRefPubMed Sobejana M, van den Hoek J, Metsios GS, Kitas GD, van der Leeden M, Verberne S, Jorstad HT, Pijnappels M, Lems WF, Nurmohamed MT, van der Esch M (2022) Exercise intervention on cardiorespiratory fitness in rheumatoid arthritis patients with high cardiovascular disease risk: a single-arm pilot study. Clin Rheumatol 41:3725–3734. https://​doi.​org/​10.​1007/​s10067-022-06343-4CrossRefPubMed
28.
Zurück zum Zitat Metsios GS, Moe RH, van der Esch M, van Zanten JJCSV, Fenton SAM, Koutedakis Y, Vitalis P, Kennedy N, Brodin N, Bostrom C, Swinnen TW, Tzika K, Niedermann K, Nikiphorou E, Fragoulis GE, Vlieland TPVM, Van den Ende CHM, Kitas GD, IMPACT-RMD Consortium (2020) The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis. Rheumatol Int 40:347–357. https://doi.org/10.1007/s00296-019-04483-6CrossRefPubMed Metsios GS, Moe RH, van der Esch M, van Zanten JJCSV, Fenton SAM, Koutedakis Y, Vitalis P, Kennedy N, Brodin N, Bostrom C, Swinnen TW, Tzika K, Niedermann K, Nikiphorou E, Fragoulis GE, Vlieland TPVM, Van den Ende CHM, Kitas GD, IMPACT-RMD Consortium (2020) The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis. Rheumatol Int 40:347–357. https://​doi.​org/​10.​1007/​s00296-019-04483-6CrossRefPubMed
31.
32.
Zurück zum Zitat Sarajlic P, Fridén C, Lund LH, Manouras A, Venkateshvaran A, Larsson SC, Nordgren B, Opava CH, Lundberg IE, Bäck M (2018) Enhanced ventricular-arterial coupling during a 2-year physical activity programme in patients with rheumatoid arthritis: a prospective substudy of the physical activity in rheumatoid arthritis 2010 trial. J Intern Med 284:664–673. https://doi.org/10.1111/joim.12715CrossRefPubMed Sarajlic P, Fridén C, Lund LH, Manouras A, Venkateshvaran A, Larsson SC, Nordgren B, Opava CH, Lundberg IE, Bäck M (2018) Enhanced ventricular-arterial coupling during a 2-year physical activity programme in patients with rheumatoid arthritis: a prospective substudy of the physical activity in rheumatoid arthritis 2010 trial. J Intern Med 284:664–673. https://​doi.​org/​10.​1111/​joim.​12715CrossRefPubMed
33.
Zurück zum Zitat Pineda-Juárez JA, Lozada-Mellado M, Hinojosa-Azaola A, García-Morales JM, Ogata-Medel M, Llorente L, Alcocer-Varela J, Orea-Tejeda A, Martín-Nares E, Castillo-Martínez L (2022) Changes in hand grip strength and body weight after a dynamic exercise program and Mediterranean diet in women with rheumatoid arthritis: a randomized clinical trial. Physiother Theory Pract 38:504–512. https://doi.org/10.1080/09593985.2020.1777605CrossRefPubMed Pineda-Juárez JA, Lozada-Mellado M, Hinojosa-Azaola A, García-Morales JM, Ogata-Medel M, Llorente L, Alcocer-Varela J, Orea-Tejeda A, Martín-Nares E, Castillo-Martínez L (2022) Changes in hand grip strength and body weight after a dynamic exercise program and Mediterranean diet in women with rheumatoid arthritis: a randomized clinical trial. Physiother Theory Pract 38:504–512. https://​doi.​org/​10.​1080/​09593985.​2020.​1777605CrossRefPubMed
38.
Zurück zum Zitat Loeppenthin K, Esbensen BA, Klausen JM, Østergaard M, Christensen JF, Tolver A, Thomsen T, Bech JS, Jennum P (2022) Efficacy and acceptability of intermittent aerobic exercise on polysomnography-measured sleep in people with rheumatoid arthritis with self-reported sleep disturbance: a randomized controlled trial. ACR Open Rheumatol 4:395–405. https://doi.org/10.1002/acr2.11403CrossRefPubMedPubMedCentral Loeppenthin K, Esbensen BA, Klausen JM, Østergaard M, Christensen JF, Tolver A, Thomsen T, Bech JS, Jennum P (2022) Efficacy and acceptability of intermittent aerobic exercise on polysomnography-measured sleep in people with rheumatoid arthritis with self-reported sleep disturbance: a randomized controlled trial. ACR Open Rheumatol 4:395–405. https://​doi.​org/​10.​1002/​acr2.​11403CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat England BR, Smith BJ, Baker NA, Barton JL, Oatis CA, Guyatt G, Anandarajah A, Carandang K, Chan KK, Constien D, Davidson E, Dodge CV, Bemis-Dougherty A, Everett S, Fisher N, Fraenkel L, Goodman SM, Lewis J, Menzies V, Moreland LW, Navarro-Millan I, Patterson S, Phillips LR, Shah N, Singh N, White D, AlHeresh R, Barbour KE, Bye T, Guglielmo D, Haberman R, Johnson T, Kleiner A, Lane CY, Li LC, Master H, Pinto D, Poole JL, Steinbarger K, Sztubinski D, Thoma L, Tsaltskan V, Turgunbaev M, Wells C, Turner AS, Treadwell JR (2023) 2022 American College of Rheumatology Guideline for exercise, rehabilitation, diet, and additional integrative interventions for rheumatoid arthritis. Arthritis Care Res (Hoboken) 75:1603–1615. https://doi.org/10.1002/acr.25117CrossRefPubMed England BR, Smith BJ, Baker NA, Barton JL, Oatis CA, Guyatt G, Anandarajah A, Carandang K, Chan KK, Constien D, Davidson E, Dodge CV, Bemis-Dougherty A, Everett S, Fisher N, Fraenkel L, Goodman SM, Lewis J, Menzies V, Moreland LW, Navarro-Millan I, Patterson S, Phillips LR, Shah N, Singh N, White D, AlHeresh R, Barbour KE, Bye T, Guglielmo D, Haberman R, Johnson T, Kleiner A, Lane CY, Li LC, Master H, Pinto D, Poole JL, Steinbarger K, Sztubinski D, Thoma L, Tsaltskan V, Turgunbaev M, Wells C, Turner AS, Treadwell JR (2023) 2022 American College of Rheumatology Guideline for exercise, rehabilitation, diet, and additional integrative interventions for rheumatoid arthritis. Arthritis Care Res (Hoboken) 75:1603–1615. https://​doi.​org/​10.​1002/​acr.​25117CrossRefPubMed
41.
42.
Zurück zum Zitat Pinto AJ, Meireles K, Peçanha T, Mazzolani BC, Smaira FI, Rezende D, Benatti FB, Ribeiro ACM, Pinto ALS, Lima FR, Shinjo SK, Dantas WS, Mellett NA, Meikle PJ, Owen N, Dunstan DW, Roschel H, Gualano B (2021) Acute cardiometabolic effects of brief active breaks in sitting for patients with rheumatoid arthritis. Am J Physiol Endocrinol Metab 321:E782–E794. https://doi.org/10.1152/ajpendo.00259.2021CrossRefPubMed Pinto AJ, Meireles K, Peçanha T, Mazzolani BC, Smaira FI, Rezende D, Benatti FB, Ribeiro ACM, Pinto ALS, Lima FR, Shinjo SK, Dantas WS, Mellett NA, Meikle PJ, Owen N, Dunstan DW, Roschel H, Gualano B (2021) Acute cardiometabolic effects of brief active breaks in sitting for patients with rheumatoid arthritis. Am J Physiol Endocrinol Metab 321:E782–E794. https://​doi.​org/​10.​1152/​ajpendo.​00259.​2021CrossRefPubMed
45.
Zurück zum Zitat Bjarnason-Wehrens B, Mayer-Berger W, Meister ER, Baum K, Hambrecht R, Gielen S, German Federation for Cardiovascular Prevention and Rehabilitation (2004) Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil 11:352–361. https://doi.org/10.1097/01.hjr.0000137692.36013.27CrossRefPubMed Bjarnason-Wehrens B, Mayer-Berger W, Meister ER, Baum K, Hambrecht R, Gielen S, German Federation for Cardiovascular Prevention and Rehabilitation (2004) Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil 11:352–361. https://​doi.​org/​10.​1097/​01.​hjr.​0000137692.​36013.​27CrossRefPubMed
46.
Zurück zum Zitat Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Piña IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T (2001) Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation 104:1694–1740. https://doi.org/10.1161/hc3901.095960CrossRefPubMed Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Piña IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T (2001) Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation 104:1694–1740. https://​doi.​org/​10.​1161/​hc3901.​095960CrossRefPubMed
47.
Zurück zum Zitat Peçanha T, Meireles K, Pinto AJ, Rezende DAN, Iraha AY, Mazzolani BC, Smaira FI, Sales ARK, Bonfiglioli K, Sá-Pinto AL, Lima FR, Irigoyen MC, Gualano B, Roschel H (2021) Increased sympathetic and haemodynamic responses to exercise and muscle metaboreflex activation in post-menopausal women with rheumatoid arthritis. J Physiol 599:927–941. https://doi.org/10.1113/JP280892CrossRefPubMed Peçanha T, Meireles K, Pinto AJ, Rezende DAN, Iraha AY, Mazzolani BC, Smaira FI, Sales ARK, Bonfiglioli K, Sá-Pinto AL, Lima FR, Irigoyen MC, Gualano B, Roschel H (2021) Increased sympathetic and haemodynamic responses to exercise and muscle metaboreflex activation in post-menopausal women with rheumatoid arthritis. J Physiol 599:927–941. https://​doi.​org/​10.​1113/​JP280892CrossRefPubMed
61.
Zurück zum Zitat Rausch Osthoff AK, Niedermann K, Braun J, Adams J, Brodin N, Dagfinrud H, Duruoz T, Esbensen BA, Günther KP, Hurkmans E, Juhl CB, Kennedy N, Kiltz U, Knittle K, Nurmohamed M, Pais S, Severijns G, Swinnen TW, Pitsillidou IA, Warburton L, Yankov Z, Vliet Vlieland TPM (2018) 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 77:1251–1260. https://doi.org/10.1136/annrheumdis-2018-213585CrossRefPubMed Rausch Osthoff AK, Niedermann K, Braun J, Adams J, Brodin N, Dagfinrud H, Duruoz T, Esbensen BA, Günther KP, Hurkmans E, Juhl CB, Kennedy N, Kiltz U, Knittle K, Nurmohamed M, Pais S, Severijns G, Swinnen TW, Pitsillidou IA, Warburton L, Yankov Z, Vliet Vlieland TPM (2018) 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 77:1251–1260. https://​doi.​org/​10.​1136/​annrheumdis-2018-213585CrossRefPubMed
63.
Zurück zum Zitat Drosos GC, Vedder D, Houben E, Boekel L, Atzeni F, Badreh S, Boumpas DT, Brodin N, Bruce IN, González-Gay MÁ, Jacobsen S, Kerekes G, Marchiori F, Mukhtyar C, Ramos-Casals M, Sattar N, Schreiber K, Sciascia S, Svenungsson E, Szekanecz Z, Tausche AK, Tyndall A, van Halm V, Voskuyl A, Macfarlane GJ, Ward MM, Nurmohamed MT, Tektonidou MG (2022) EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome. Ann Rheum Dis 81:768–779. https://doi.org/10.1136/annrheumdis-2021-221733CrossRefPubMed Drosos GC, Vedder D, Houben E, Boekel L, Atzeni F, Badreh S, Boumpas DT, Brodin N, Bruce IN, González-Gay MÁ, Jacobsen S, Kerekes G, Marchiori F, Mukhtyar C, Ramos-Casals M, Sattar N, Schreiber K, Sciascia S, Svenungsson E, Szekanecz Z, Tausche AK, Tyndall A, van Halm V, Voskuyl A, Macfarlane GJ, Ward MM, Nurmohamed MT, Tektonidou MG (2022) EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome. Ann Rheum Dis 81:768–779. https://​doi.​org/​10.​1136/​annrheumdis-2021-221733CrossRefPubMed
68.
Zurück zum Zitat Li C, Wang XR, Ji HJ, Zhang XY, Li XF, Wang LZ, Wang CH, Wang YF, Yang R, Wang GC, Lu X, Zhu P, Chen LN, Jin HT, Liu JT, Liu XY, Sun L, Chen HY, Wei P, Wang JX, Cui LF, Shu R, Liu BL, Zhang ZL, Li GT, Li ZB, Yang J, Li JF, Jia B, Zhang FX, Tao JM, Han SL, Lin JY, Wei MQ, Liu XM, Ke D, Hu SX, Ye C, Yang XY, Li H, Huang CB, Gao M, Lai B, Li XF, Song LJ, Wang Y, Wang XY, Tang YD, Su Y, Mu R, Li ZG (2017) Cardiovascular disease in rheumatoid arthritis: medications and risk factors in China. Clin Rheumatol 36:1023–1029. https://doi.org/10.1007/s10067-017-3596-7CrossRefPubMed Li C, Wang XR, Ji HJ, Zhang XY, Li XF, Wang LZ, Wang CH, Wang YF, Yang R, Wang GC, Lu X, Zhu P, Chen LN, Jin HT, Liu JT, Liu XY, Sun L, Chen HY, Wei P, Wang JX, Cui LF, Shu R, Liu BL, Zhang ZL, Li GT, Li ZB, Yang J, Li JF, Jia B, Zhang FX, Tao JM, Han SL, Lin JY, Wei MQ, Liu XM, Ke D, Hu SX, Ye C, Yang XY, Li H, Huang CB, Gao M, Lai B, Li XF, Song LJ, Wang Y, Wang XY, Tang YD, Su Y, Mu R, Li ZG (2017) Cardiovascular disease in rheumatoid arthritis: medications and risk factors in China. Clin Rheumatol 36:1023–1029. https://​doi.​org/​10.​1007/​s10067-017-3596-7CrossRefPubMed
73.
Zurück zum Zitat Ghadieh AS, Saab B (2015) Evidence for exercise training in the management of hypertension in adults. Can Fam Physician 61:233–239PubMedPubMedCentral Ghadieh AS, Saab B (2015) Evidence for exercise training in the management of hypertension in adults. Can Fam Physician 61:233–239PubMedPubMedCentral
Metadaten
Titel
Exercise therapy for improving cardiovascular health in rheumatoid arthritis
verfasst von
Ilke Coskun Benlidayi
Publikationsdatum
31.10.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Rheumatology International / Ausgabe 1/2024
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-023-05492-2

Weitere Artikel der Ausgabe 1/2024

Rheumatology International 1/2024 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.