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The SWET group completed aerobic training (150 minutes\/week moderate\u2010to\u2010vigorous intensity), resistance training (two days\/week), and a hypocaloric diet (7% weight loss goal). The CHAT control group completed two lifestyle counseling sessions followed by monthly check\u2010ins. The primary outcome was a composite metabolic syndrome <jats:italic>z<\/jats:italic>\u2010score (MSSc) derived from fasting glucose, triglycerides, high density lipoprotein\u2013cholesterol, minimal waist circumference, and mean arterial pressure. Secondary outcomes included RA disease activity and patient\u2010reported outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both groups improved MSSc (absolute change \u22121.67 \u00b1\u20090.64 in SWET; \u22121.34 \u00b1\u20091.30 in CHAT; <jats:italic>P<\/jats:italic> &lt;\u20090.01 for both groups) with no between\u2010group difference. Compared with CHAT, SWET significantly improved body weight, fat mass, Disease Activity Score\u201028 C\u2010reactive protein, and patient\u2010reported physical health, physical function, mental health, and fatigue (<jats:italic>P<\/jats:italic> &lt;\u20090.04 for all between\u2010group comparisons). Based on canonical correlations for fat mass, cardiorespiratory fitness, and leg strength, component\u2010specific effects were strongest for (1) weight loss improving MSSc, physical health, and mental health; (2) aerobic training improving physical function and fatigue; and (3) resistance training improving Disease Activity Score\u201028 C\u2010reactive protein.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In older patients with RA and overweight\/obesity, 16\u2009weeks of remotely supervised weight loss, aerobic training, and resistance training improve cardiometabolic health, patient\u2010reported outcomes, and disease activity. Less intensive lifestyle counseling similarly improves cardiovascular disease risk profiles, suggesting an important role for integrative interventions in the routine clinical care of this at\u2010risk RA population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11639","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T05:58:23Z","timestamp":1703138303000},"page":"124-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Effect of Remotely Supervised Weight Loss and Exercise Training Versus Lifestyle Counseling on Cardiovascular Risk and Clinical Outcomes in Older Adults With Rheumatoid Arthritis: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1847-0660","authenticated-orcid":false,"given":"Brian J.","family":"Andonian","sequence":"first","affiliation":[{"name":"Duke University School of Medicine, Duke Molecular 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