Effectiveness of a comprehensive home-based cardiac rehabilitation intervention on the health promotion of patients with coronary artery disease: A randomized double-blind clinical trial

Abstract

BACKGROUND: This study aimed to assess the efficacy of a comprehensive home-based cardiac rehabilitation (HBCR) program in promoting health outcomes among Iranian patients with coronary artery disease (CAD). METHODS: This randomized, double-blind, clinical trial was conducted on 259 patients with CAD. Participants were allocated to receive either usual care or the HBCR program. Anthropometric indices, lipid profiles, and cardiovascular events were evaluated at baseline and during the follow-up periods. RESULTS: Changes in serum low-density lipoprotein cholesterol (LDL-C) and arterial blood pressure did not differ significantly between the groups. Body mass index (BMI) was significantly reduced in the HBCR group compared to the control group (P = 0.004). At the study endpoint, hip circumference also demonstrated a more favorable status in the HBCR group (P = 0.002). High-density lipoprotein cholesterol (HDL-C) serum levels improved more prominently in the HBCR group (P = 0.030). Triglyceride (TG) levels showed a similar pattern in both groups, but the overall increase after 12 months was significantly higher in the control group (P = 0.019). Serum total cholesterol (TC) continuously increased in the control group, whereas it decreased in the HBCR group at 12 months, remaining significantly lower than in the control group overall (P = 0.003). Regarding cardiovascular events, mortality was significantly higher in the control group after 18 months (P = 0.007). Additionally, the rate of return to work after 6 months was significantly higher in the HBCR group (P = 0.020). CONCLUSION: This study demonstrated that a home-based cardiac rehabilitation program is an effective intervention for patients with CAD, leading to superior clinical outcomes.