Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses

Abstract Background Cardiovascular disease (CVD) has become the leading cause of competitive mortality in female breast cancer (BC). Regular aerobic exercise (AE) has been widely accepted as an effective intervention to reduce cardiovascular risk in a variety of different clinical conditions. This s...

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Main Authors: Qian Jiao, Bowen Xu, Chao Meng, Fan Xu, Shanshan Li, Jiayi Zhong, Min Yang, Jiang Li, Haixia Li
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-20592-9
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author Qian Jiao
Bowen Xu
Chao Meng
Fan Xu
Shanshan Li
Jiayi Zhong
Min Yang
Jiang Li
Haixia Li
author_facet Qian Jiao
Bowen Xu
Chao Meng
Fan Xu
Shanshan Li
Jiayi Zhong
Min Yang
Jiang Li
Haixia Li
author_sort Qian Jiao
collection DOAJ
description Abstract Background Cardiovascular disease (CVD) has become the leading cause of competitive mortality in female breast cancer (BC). Regular aerobic exercise (AE) has been widely accepted as an effective intervention to reduce cardiovascular risk in a variety of different clinical conditions. This study is aimed at evaluating the efficacy and safety of AE on cardiovascular risk factors in female BC and assessing the quality of the synthesized evidence. Methods We searched five English databases (Cochrane Library, PubMed, Embase, Scopus, and Web of Science) from inception to January 2023. Randomized controlled trials (RCTs) and cohort trials studying the effects of AE intervention on cardiovascular disease risk in female breast cancer were included. We used Stata 16 for data synthesis, Risk of Bias 2, and the Newcastle–Ottawa Scale for methodological quality evaluation and assessed the certainty of the synthesized evidence in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Forty RCTs and 6 cohort trials involving 44,877 BC patients showed AE reduced the incidence of CVD events by 29.4% [risk ratio (RR) = 0.706, 95% confidence interval (CI) (0.659, 0.757), low certainty] and coronary artery disease events by 36% [RR = 0.640, 95% CI (0.561, 0.729), low certainty]. AE improved LVEF, and reduced weight and hip circumference. The subgroup analysis results showed that nonlinear AE increased VO2max by 5.354 ml·kg·min−1 [mean difference (MD) = 5.354, 95% CI (2.645, 8.062), very low certainty] and reduced fat mass by 4.256 kg [MD = 4.256, 95% CI (-3.839, -0.094), very low certainty]. While linear AE reduced low-density lipoprotein cholesterol (LDL-C) by 8.534 mg/dL [MD = -8.534, 95% CI (-15.511, -1.557), low certainty]. The sensitivity analysis results showed that each trial did not affect the impact index of the highly heterogeneous outcomes. Conclusions Our study indicates that AE has a positive effect in reducing cardiovascular risk factors. The individualization principle of AE deserves more attention in the future. This will provide new ideas to reduce CVD events and improve the quality of life in female BC patients. However, further research on AE in female BC should take into account long-term and well-designed administration to draw definitive conclusions.
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spelling doaj-art-c43c43e50b6a4bf6a5a9ca9a90c2ea382024-12-08T12:48:03ZengBMCBMC Public Health1471-24582024-12-0124112010.1186/s12889-024-20592-9Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analysesQian Jiao0Bowen Xu1Chao Meng2Fan Xu3Shanshan Li4Jiayi Zhong5Min Yang6Jiang Li7Haixia Li8Guang’ anmen Hospital of Chinese Academy of Chinese Medical SciencesHunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityGuang’ anmen Hospital of Chinese Academy of Chinese Medical SciencesGuang’ anmen Hospital of Chinese Academy of Chinese Medical SciencesGuang’ anmen Hospital of Chinese Academy of Chinese Medical SciencesGuang’ anmen Hospital of Chinese Academy of Chinese Medical SciencesCancer Hospital Chinese Academy of Medical SciencesCancer Hospital Chinese Academy of Medical SciencesGuang’ anmen Hospital of Chinese Academy of Chinese Medical SciencesAbstract Background Cardiovascular disease (CVD) has become the leading cause of competitive mortality in female breast cancer (BC). Regular aerobic exercise (AE) has been widely accepted as an effective intervention to reduce cardiovascular risk in a variety of different clinical conditions. This study is aimed at evaluating the efficacy and safety of AE on cardiovascular risk factors in female BC and assessing the quality of the synthesized evidence. Methods We searched five English databases (Cochrane Library, PubMed, Embase, Scopus, and Web of Science) from inception to January 2023. Randomized controlled trials (RCTs) and cohort trials studying the effects of AE intervention on cardiovascular disease risk in female breast cancer were included. We used Stata 16 for data synthesis, Risk of Bias 2, and the Newcastle–Ottawa Scale for methodological quality evaluation and assessed the certainty of the synthesized evidence in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Forty RCTs and 6 cohort trials involving 44,877 BC patients showed AE reduced the incidence of CVD events by 29.4% [risk ratio (RR) = 0.706, 95% confidence interval (CI) (0.659, 0.757), low certainty] and coronary artery disease events by 36% [RR = 0.640, 95% CI (0.561, 0.729), low certainty]. AE improved LVEF, and reduced weight and hip circumference. The subgroup analysis results showed that nonlinear AE increased VO2max by 5.354 ml·kg·min−1 [mean difference (MD) = 5.354, 95% CI (2.645, 8.062), very low certainty] and reduced fat mass by 4.256 kg [MD = 4.256, 95% CI (-3.839, -0.094), very low certainty]. While linear AE reduced low-density lipoprotein cholesterol (LDL-C) by 8.534 mg/dL [MD = -8.534, 95% CI (-15.511, -1.557), low certainty]. The sensitivity analysis results showed that each trial did not affect the impact index of the highly heterogeneous outcomes. Conclusions Our study indicates that AE has a positive effect in reducing cardiovascular risk factors. The individualization principle of AE deserves more attention in the future. This will provide new ideas to reduce CVD events and improve the quality of life in female BC patients. However, further research on AE in female BC should take into account long-term and well-designed administration to draw definitive conclusions.https://doi.org/10.1186/s12889-024-20592-9Breast cancerAerobic exerciseCardiovascular disease riskSystematic review
spellingShingle Qian Jiao
Bowen Xu
Chao Meng
Fan Xu
Shanshan Li
Jiayi Zhong
Min Yang
Jiang Li
Haixia Li
Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses
BMC Public Health
Breast cancer
Aerobic exercise
Cardiovascular disease risk
Systematic review
title Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses
title_full Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses
title_fullStr Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses
title_full_unstemmed Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses
title_short Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses
title_sort effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer a systematic review with meta analyses
topic Breast cancer
Aerobic exercise
Cardiovascular disease risk
Systematic review
url https://doi.org/10.1186/s12889-024-20592-9
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