Abstract
BACKGROUND: Nurse-led cardiac rehabilitation (NLCR) is a patient-centered approach for managing cardiovascular disease (CVD) risk factors, but its physiological effects are unclear. This study evaluates NLCR's impact on key physiological parameters, including systolic and diastolic blood pressure (SBP, DBP), body mass index (BMI), body weight, and waist circumference (WC). METHODS: PubMed, Scopus, Embase, Cochrane Library, Web of Science, Google Scholar, ClinicalTrials.gov, and International Clinical Trials Registry Platform were searched from inception to May 30, 2025, to identify randomized controlled trials (RCTs) comparing NLCR to usual care in adult patients with CVDs (e.g., coronary heart disease, acute coronary syndrome, myocardial infarction, chronic heart failure, and atrial fibrillation). Standardized mean differences (SMDs) were pooled using random-effects models, and heterogeneity, subgroup, and sensitivity analyses were performed. RESULTS: Eleven RCTs (15 records, N = 1146 participants) were included, with mean ages of ~59 years in both intervention (133 male, 415 female) and control groups (126 male, 407 female). Nurse-led cardiac rehabilitation significantly reduced SBP (SMD = -0.20; 95% CI: 0.34 to -0.05) and DBP (SMD = -0.20; 95% CI: -0.37 to -0.03) compared to usual care, with low heterogeneity across studies. A significant reduction in body weight was also observed (SMD = -0.27; 95% CI: -0.46 to -0.07), while changes in BMI and WC did not reach statistical significance. A 12-week follow-up optimized blood pressure improvements, while longer durations better influenced anthropometric outcomes. CONCLUSION: Nurse-led cardiac rehabilitation improves hemodynamics and modestly reduces weight in cardiac patients, supporting its inclusion in standard rehab protocols. Optimizing program duration may enhance outcomes. Future research should assess NLCR's components and long-term benefits. #W.Z. and Q.W. contributed equally in this study.