Valoración del control de los factores de riesgo cardiovascular en mujeres menopáusicas obesas tras el seguimiento de un programa estructurado de educación dietética y ejercicio físico. (Programa SÍSIFO)

Effect of physical exercise on cardiometabolic parameters in post-menopause: an integrative review

Abstract Objective: To identify the evidence available in literature which relates the practice of physical exercise to improvements in the cardiovascular and metabolic parameters of postmenopausal women. Method: A search was performed of works published between 2008 and 2018 included in the MEDLINE, BDENF, IBCS and LILACS databases. Of the 792 studies identified, 23 met the inclusion criteria. Results: Following analysis, the studies were separated into three categories. In the first category it was observed that physical exercise improved lipid metabolism, reduced abdominal circumference and promoted weight loss. The second category revealed that physical exercise reduced systolic blood pressure, prevented the development of arterial hypertension and reduced the release of sympathomimetic hormones. In the third category the studies indicated that physical exercise elevated the antioxidant mediators and reversed the oxidative stress involved in the inflammatory reactions present in cardiovascular diseases. Conclusion: The studies confirm the beneficial effects of physical exercise on the metabolic and cardiovascular parameters of postmenopausal women.

Cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. The FLAMENCO Project

OBJECTIVE

Adequate physical activity levels and a healthy lifestyle may prevent all kinds of non-communicable diseases, promote well-being and reduce health-care costs among perimenopausal women. This study assessed an exercise programme for perimenopausal women.

METHOD

A total of 150 women (aged 45-64 years) not engaged in regular physical activity were randomly assigned to either a 16 week exercise intervention or to the control group. The study was conducted from the perspective of the National Health System. Health outcomes were quality-adjusted life years (QALYs), measured by the EuroQol-5D-5L questionnaire. The total direct costs of the programme were the costs of visits to primary care, specialty care, emergency, medicines, instructor cost and infrastructure cost. The results were expressed as the incremental cost-effectiveness ratio. Sensitivity analysis was undertaken to test the robustness of the analysis.

RESULTS

Mean QALYs over 16 weeks were.228 in the control group and.230 in the intervention group (mean difference: .002; 95% confidence interval [95%CI]: -0.005 to 0.009). Improvements from baseline were greater in the intervention group in all dimensions of the EuroQol-5D-5L but not statistically significant. The total costs at the end of the intervention were 160.38 € in the control group and 167.80 € in the intervention group (mean difference: 7.42 €; 95%CI: -47 to 62). The exercise programme had an incremental cost-effectiveness ratio of 4,686 €/QALY.

CONCLUSIONS

The programme could be considered cost-effective, although the overall difference in health benefits and costs was very modest. Longer term follow-up is needed.