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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

WebMD UK Health News
Medically Reviewed by Dr Paola Accalai
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21st December 2009 - One of the most underutilised treatments for heart patients may also be one of the most effective, new research suggests.

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 1,000.

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 sessions:

  • 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 journal Circulation.

“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.

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