Cardiac Rehab is Good for Your Heart, But It’s Underutilized

By Eva Briggs, M.D.

 

Heart disease is the leading cause of death in the United States. It kills over 900,000 people per year and affects many more.

Cardiac rehabilitation, a medically supervised program involving multiple disciplines, is designed to assist heart disease patients to reduce the long-term effects of recent heart problems or diagnoses, and to reduce the worsening of chronic conditions.

Cardiac rehab is underutilized. Only 20-30% of eligible patients actually participate.

People who might benefit are those who have had a heart attack, patients with angina, people who have undergone placement of a stent or have undergone bypass surgery to open their coronary arteries, those with heart valve disease, heart transplant recipients or other cardiac surgery patients.

Cardiac rehab traditionally is delivered in major hospitals or specialized centers. In Central New York,  St. Joseph’s, Crouse  and Upstate University Hospital offer cardiac rehab programs. In some cases, cardiac rehab can be done through a virtual home-based program, which is helpful for patients for whom traveling to a rehab center several times per week is difficult. In Central New York, with our often-treacherous winter driving conditions, I can see the appeal of a virtual program! Cardiac rehab programs typically last two to three months, plus a maintenance phase.

Disciplines involved include:

• Cardiology to oversee the treatment plan and manage medications.

• Exercise physiology to develop personalized and monitored exercise programs aimed at improving strength, exercise tolerance, balance, and flexibility.

• Nursing to monitor blood pressure and heart rate, provide patient education, and help manage risk factors.

• Behavioral health/psychology to assist with the stress and emotional reactions to heart disease.

• Physical therapy and occupational therapy to help patients learn to manage daily activities.

• Dietitians to aid patients to plan and implement heart-healthy diets and eating patterns.

• Tobacco cessation specialists for those who use tobacco products.

Programs are divided into several phases. First is an inpatient phase for hospitalized patients.  Phase 2 is the intensive outpatient phase, with one or more visits per week for two to three 3 months. And phase 3 is a maintenance phase.

Benefits of cardiac rehab are many.

Patients improve the ability to utilize oxygen leading to reduced shortness of breath. They develop lower heart rates and improved cardiac output (the amount of blood the heart can pump out into the circulation.) The quality of life improves due to better functional capacity and improved exercise tolerance.  Health outcomes include reduced mortality, reduced future cardiac events and hospitalizations, and reduced health care costs.

People who complete cardiac rehab have a 20-30% lower risk of dying over the next five years compared to those who don’t complete a program. Patients potentially have improved mental health with less anxiety and depression.

If you think that you could be helped by cardiac rehab, the first step is to request a referral from your cardiologist or primary care provider. That will start the process. The program will schedule an initial consultation to assess your needs and develop an appropriate program.