OP0173-HPR BENEFICIAL EFFECTS OF HIGH INTENSITY EXERCISE ON CARDIOVASCULAR HEALTH IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: A. Bilberg, K. Mannerkorpi, S. Svedlund, M. Borjesson, J. Bjersing
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD) which is linked to the systemic inflammation and increased prevalence of traditional CVD risk factors, including physical inactivity. There is an inverse association between cardiorespiratory fitness (CRF) and CVD risk profile in RA. High intensity aerobic interval training is a time efficient method with the potential for greater physiological response than continuous moderate intensity exercise on CRF. However, randomized controlled trials evaluating the effects of high-intensity interval training in RA is sparse. <h3>Objectives:</h3> To evaluate the effect of 12-weeks of high-intensity exercise on cardiorespiratory fitness and body compositions in patients with RA. <h3>Methods:</h3> Patients with RA (ACR/EULAR 1987/2010 criteria), disease duration &gt; 12 months, were recruited and randomised to either an intervention group (n=43) or a control group (n=44). The exercise program of 12 weeks comprised supervised high-intensity interval training 4x4 minutes at 90-95% of HRmax, and strength exercise two times per week, plus an additional non-supervised aerobic session on moderate intensity of the patient´s own choice. The controls received individual information for physical activity according to the general health recommendations and were encouraged to be active on moderate intensive level ≥150 minutes/week. Primary outcome was change in cardiorespiratory fitness; maximal oxygen uptake (VO<sub>2</sub>mL/ kg/min) from baseline and 3 months obtained with a maximal cardiopulmonary exercise test (CPET) on a stationary cycle ergometric. Secondary outcome was change in body composition; weight, BMI-score and waist circumference and disease activity from baseline and 3 months. Group differences were assessed with the change from baseline to 3 months using Fisher´s non-parametric permutation test. <h3>Results:</h3> In total, 87 patients, 85% female and mean age 48 years were included in the assessor blinded multicentre controlled study. A total of 77 patients completed the CPET at 3 months, 41 in the intervention group (IG) and 36 in the control group (CG). The IG had a 3.54 (95% CI 2.05; 5.00) mL/kg/min (p&lt; 0.001) higher VO<sub>2</sub>max compared to the CG at 3 months. A significant between group difference of change was found for waist circumference -2.6 (95% CI -5.09; -0.18) cm (p=0.035), in favour for the IG, while the weight and BMI-score did not change. Disease activity assessed with DAS28-ESR did not change and remained low in both groups, Table 1. <h3>Conclusion:</h3> A 12-weeks supervised exercise program of high intensity had beneficial effects on cardiorespiratory fitness and body composition without deterioration in disease activity. This indicates that the exercise intervention is feasible and can be used to improve important cardiovascular risk factors in patients with RA with a low disease activity. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>