[Reducing cholesterol in cardiovascular rehabilitation--exercise versus drug therapy]

Prospective epidemiological studies have proven a close link between the improvement of the lipoprotein profile and reduction of coronary heart mortality in coronary heart disease (CHD) patients. Both, regular physical activity and pharmacological intervention are capable of improving the lipoprotein profile and may independently reduce coronary stenoses and cardiac events in CHD patients. Because of the multifactorial genesis of atherosclerosis, regular physical activity is of major importance for cardiac rehabilitation and improvements of other risk factors besides the lipoprotein profile e.g. rheology, hypercoagulability, hypertension, peripheral insulin resistance and oxidative status may be expected. The combination of life-style changes e.g. physical activity, diet and smoking cessation together with pharmacological intervention, if risk factors remain high, seems to be the best therapy for patients with CHD. A sole pharmacological intervention seems to be insufficient.