Cardiac rehab: More is better, a study finds
The longer heart patients attend cardiac rehabilitation programmes, the lower their risk for death and heart attacks, a new study finds
21st December 2009 - One of the most underutilised treatments for
heart patients may also be one of the most effective, new research
According to US scientists, the longer patients aged over 65 participate in
cardiac rehabilitation programmes following heart-related hospital admissions,
the better their outcomes.
NHS figures show approximately six in 1,000 men in the UK aged between 30-69
years suffer a heart attack each year. The figure for women is lower, at two in
What is cardiac rehab?
The goal of cardiac rehabilitation is to slow or even reverse the
progression of cardiovascular disease by educating patients about their disease
and getting them to follow a medically supervised exercise programme.
Sessions in the US are typically held two or three times a week for several
months after a heart-related hospital discharge, but only about 10% to 20% of
patients who could benefit from the programmes actually attend them, rehab
specialist Dr David Prince of the Montefiore Medical Centre tells us.
“Many eligible patients are never referred for cardiac rehab and access is
also an issue,” Dr Prince says.
Cardiac rehab: More is better
The US doesn’t have an equivalent of the NHS, but it does have the Medicare
social insurance system for people over 65. Recipients are entitled to 36
cardiac rehab sessions following admission to hospital for a heart attack,
bypass surgery or many other heart-related events, yet most eligible patients
end up attending far fewer sessions or none at all.
In an effort to determine if more is better when it comes to cardiac
rehabilitation, researchers analysed data from 5% of US Medicare beneficiaries,
including more than 30,000 heart patients who had participated in at least one
cardiac rehabilitation session between 2000 and 2005.
About half the patients attended 24 sessions or fewer, biostatistician and
lead researcher Bradley Hammill, tells us.
Over roughly four years of follow-up, patients who attended all 36
- were 47% less likely to die and 31% less likely to have a heart attack than
patients who attended just one session
- were 22% less likely to die and 23% less likely to have a heart attack than
patients who attended 12 sessions
- were 14% less likely to die and 12% less likely to have a heart attack than
patients who attended 24 sessions.
The study will appear in the next issue of the American Heart Association
“Our findings indicate that more cardiac rehabilitation is better in almost
every situation,” Bradley Hammill says. “It may be that people who finish 36
sessions are already healthier or more diligent about their health. Or it may
be that the programmes really do change behaviours and lower risk.”
Daisy McFadden’s story
99-year-old Daisy McFadden has been attending Montefiore Medical Centre’s
Cardiac Recovery Programme for eleven years, ever since she had triple bypass
surgery at the age of 88.