Abstract
Exercise training is recommended in coronary heart disease (CHD) and type 2 diabetes (T2DM) patients alike; however, uncertainty remains on the influence of exercise intensity and duration in older patients with both entities. To address this, we performed a secondary analysis including 201 patients (67.9 ± 8.2 years; 84.1% men) from the LeIKD trial (NCT038359), which introduced 6 months of home-based telemedicine-supported exercise intervention in patients with CHD and T2DM. We assessed the relationships between exercise duration and intensity with change in peak oxygen uptake (V̇O(2)peak) (simple and multiple regression analyses, α = 0.05). V̇O(2)peak increased by 0.42 mL/kg/min per hour of endurance exercise/week (95% CI: 0.17-0.66, p = 0.001). Exercise intensity was not significantly associated with the change in V̇O(2)peak (p = 0.10). In a subgroup of patients with high adherence (≥ 66.7% of prescribed total duration and meeting prescribed exercise duration in ≥ 50% of weeks of intervention), a 10% increase in exercise intensity (mean % heart rate reserve (HRR)) was associated with an increase in V̇O(2)peak of 0.26 mL/kg/min (95% CI: 0.00-0.52; p = 0.05). Longer training duration within the initial 2 weeks of intervention was significantly associated with high adherence over 6 months (increased likelihood per 10 min/week: OR of 1.09 [95% CI: 1.05-1.14], p < 0.001). Therefore, exercise duration but not intensity influences changes in V̇O(2)peak during exercise intervention in a high-risk population of older patients with CHD and T2DM. In patients with high adherence to exercise duration, higher exercise intensity led to an additional increase in V̇O(2)peak. Training duration within the first 2 weeks was an important predictor of long-term adherence. Trial Registration: https://www.clinicaltrials.gov: Identifier: NCT038359.