Primary Prevention Effects Of Moderate Intensity Aerobic Exercise Combined With Resistance Training On Atherosclerotic Cardiovascular Disease (ASCVD) In Postmenopausal Women

Objective:To study the effects of moderate intensity aerobic exercise combined with resistance training on lipid metabolism and vascular inflammatory response in early postmenopausal women with hyperlipemia, so as to provide research basis for postmenopausal women to carry out ASCVD primary prevention scientifically and regularly.Method:The trial include 90 early postmenopausal women as research objects from 2013 September to 2014 September. All of them came to Cardiology Department in Jiangsu Provincial Hospital of TCM for treatment because of hyperlipemia and mildly atypical anginal symptoms, and were suspected of CHD stable angina. By the method of clinical randomized control,90 cases were divided into control group(group A), moderate intensity aerobic exercise group (B group) and the combination of moderate intensity aerobic exercise and resistance training group (C group),30 cases in each group. All patients were rendered with therapeutic lifestyle education (including diet adjustment, psychological and behavioral intervention, quit smoking, and so on). According to the Chinese adult dyslipidemia prevention and treatment guide, all moderate and high-risk patients were treated by appropriate lipid drug therapy. Patients of group A without regular exercise training, while patients of group B were directed to do moderate intensity aerobic exercise, and patients of group C to do moderate intensity aerobic combined with resistance exercise. Patients of group B and C did exercise intervention three times weekly on Monday, Wednesday and Friday, in succession for 12 weeks. Before and after the intervention, elbow vein blood from all the patients on a balanced diet and fasting condition were extracted to test serum TC, TG, LDL-C, HDL-C, TNF-α, IL-6 and E2 levels, and then the non-HDL-C content were calculated. After intervention for 12 weeks, the test data of three groups were compared and statistically analyzed, then results and conclusions were drew.Result:1. Lipid metabolism indicators:before and after the intervention, levels of serum LDL-C, non-HDL-C and TG in each group were reduced. Level of serum HDL-C in group A has no obvious difference before and after the intervention (P>0.05), while which in group B and C had increased, showing significant difference (P＜0.05); Compared with group A, levels of serum LDL-C, non-HDL-C and TG was lower, though HDL-C was higher in group B and C after the intervention, the difference were statistically significant (P＜0.05); Comparison between group C and group B after the intervention showing that levels of serum LDL-C, non-HDL-C and TG was significantly much lower and HDL-C much higher in group C than that in group B (P＜0.05)2. Inflammatory factor indicators:comparison before and after the intervention showed that levels of serum TNF-a and IL-6 in each group decreased significantly (P< 0.05); Compared with group A, levels of serum TNF-a and IL-6 in group B and C after the intervention were significantly lower (P<0.05); While the comparison between group B and group C after the intervention showed that levels of serum TNF-a and IL-6 in group C was much lower than that in group B, the difference was significant (P<0.05)3. Estrogen level:comparison before and after the intervention showed that the level of serum E2 in group A decreased significantly (P＜0.05), while the change of that in group B and C showed no statistical difference (P>0.05); Compared with group A, the level of serum E2 in group B and C after the intervention were significantly higher (P＜0.05), while there were no obvious difference in which between group B and group C (P>0.05)Conclusion:1. Moderate intensity aerobic exercise and resistance training for 12 weeks can effectively reduce the serum LDL-C、non-HDL-C、TG, and increase HDL-C levels, so as to improve lipid metabolism in postmenopausal women; Compared with the pure moderate intensity aerobic exercise, moderate intensity aerobic exercise combined with resistance training had a better effect to regulate lipid metabolism.2. Moderate intensity aerobic exercise and resistance training for 12 weeks can effectively reduce the serum TNF-a and IL-6 levels, so as to stabilize the state of vascular inflammation in postmenopausal women; Compared with the pure moderate intensity aerobic exercise, moderate intensity aerobic exercise combined with resistance training showed a better anti-inflammatory effect.3. Moderate intensity aerobic exercise and resistance training for 12 weeks can not reverse the decrease of E2 level in early postmenopausal women, but to some extent slowed its decline trend; There was no significant difference in slowing its trend between moderate intensity aerobic exercise and moderate intensity aerobic exercise combined with resistance training.4. Moderate intensity aerobic exercise and resistance training obviously improved the state of lipid metabolism and vascular inflammation in postmenopausal women, also can to some extent slow the decline trend of estrogen level. Moderate intensity aerobic exercise combined with resistance training can be viewed as effective intervention for ASCVD primary prevention in postmenopausal women.