Cardiac rehabilitation offers many health benefits to older people with heart problems, but a new study found that few patients who could benefit from it are actually participating in it.
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Cardiac rehab typically includes supervised exercise programs, and education on nutrition, medication use and general lifestyle improvements, to help patients with heart disease get stronger and be healthier. Most patients attend cardiac rehab sessions two or three times a week for about 12 weeks after having a heart attack or other cardiac problem.
The recent study, done at Duke University, looked at about 58,000 patients 65 or older who would have benefited from cardiac rehab from 2007 through 2010. It found that only about 62 percent of them were referred to cardiac rehab by their doctor, and only about 23 percent went at all. Just 5 percent completed the full 36 weeks that are recommended.
Chad Raymond, DO, a staff cardiologist in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic, is a big advocate of cardiac rehab. He says this study is not the first to point out that these types of programs are not used as widely as they should be.
However, he notes that these numbers are better than ones that he has seen in the past. “The participation rate for older patients has doubled in the past decade, but we have a long way to go,” he says.
“Older patients tend to get the most benefit from cardiac rehab (especially older females), particularly when it comes to living longer and feeling better, so it is unfortunate that many of them are not participating,” he adds. “I hope this study will bring more attention to this area and encourage internists and cardiologists to discuss the benefits of cardiac rehab with their patients.”
Reducing death rates
Cardiac rehab reduces death rates after a heart attack just as much, if not more, than medicines such as beta blockers or statins. Patients who can benefit include those who have had a heart attack, coronary artery bypass surgery, cardiac stents, valve surgery, heart transplants, congestive heart failure, an abnormal heart rhythm or chest pain caused by coronary artery disease.
Dr. Raymond says that patients who go to cardiac rehab after such problems have 25 to 30 percent fewer fatal heart events afterward. They also tend to lose weight, lower their cholesterol, improve their diabetes and reduce anxiety and depression. Many people develop friendships with their fellow participants along the way.
“People tend to feel more equipped to handle daily activities, as they improve their overall quality of life and their emotional outlook through cardiac rehab,” he says.
What to look for
If you are seeking a cardiac rehab program, he advises looking for one that includes specialized doctors, nurses, exercise physiologists, psychologists and dietitians. The staff should be certified in advanced cardiac life support, just in case there is an emergency. Ideally the program is certified by the American Association of Cardiovascular & Pulmonary Rehabilitation.
“A good program will start by studying your needs and designing a program just for you,” he says.
Ask your cardiologist where he or she suggests you go. “Don’t forget that you will need a referral to enter the program,” Dr. Raymond adds. “Your doctor will get regular reports back with updates on your progress.”