Iris den Uijl, Nienke ter Hoeve, Madoka Sunamura, Henk J. Stam, Mattie J. Lenzen, Victor J. van den Berg, Eric Boersma, Rita J.G. van den Berg-Emons
Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. E-mail: I.denuijl@erasmusmc.nl
DOI: 10.2340/16501977-2702

Objective: To investigate the relation between body mass index class and changes in health-related quality of life in patients participating in cardiac rehabilitation.
Design: Prospective cohort study.
Patients: A total of 503 patients with acute coronary syndrome.
Methods: Data from the OPTICARE trial were used, in which health-related quality of life was measured with the MacNew Heart Disease HRQOL Instrument at the start, directly after, and 9 months after completion of cardiac rehabilitation. Patients were classed as normal weight, overweight, or obese.
Results: During cardiac rehabilitation, global health-related quality of life improved in patients in all classes of body mass index. Patients classed as overweight had a significantly greater improvement in social participation than those classed as normal weight (5. 51–6. 02 compared with 5. 73–5. 93, respectively; difference in change 0. 30, p = 0. 025). After completion of cardiac rehabilitation, health-related quality of life continued to improve similarly in patients in all classes of body mass index.
Conclusion: Health-related quality of life improved during cardiac rehabilitation in patients of all classes of body mass index. Patients classed as overweight showed the greatest improvement. The beneficial effects were maintained during extended follow-up after completion of cardiac rehabilitation.

Patients with cardiovascular disease are referred to cardiac rehabilitation to help them adopt a healthier lifestyle and achieve a stable psychological status. How-ever, cardiac rehabilitation programmes are probably not suitable for patients of all body mass indexes. Patients who are classed as obese may experience more difficulty in changing their current lifestyle to a heal-thier one. During cardiac rehabilitation their quality of life might not improve as much as in patients of normal weight. This study investigated the differences between body mass index classes with regard to improvement in quality of life. The results showed that, during cardiac rehabilitation, obese patients undergo the same improvements as patients of normal weight. Patients who are overweight showed a greater improvement in quality of life. It does not seem to be necessary to adjust cardiac rehabilitation programmes for patients who are obese; at least not with respect to improving quality of life.