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AHA Encourages Cardiac Rehab Programs
Less than 20 percent of the two million people who should be participating in cardiac
rehabilitation and secondary prevention protocols are doing so, which puts them at increased
risk of a recurrent heart attack. The American Heart Association has revised their 1994 statement
of optimal rehabilitation to include Internet-based therapies, among other new suggestions, including
increased emphasis by physicians on the rehab programs. Physicians, they say, should aggressively
encourage patients to exercise and follow cardiac rehabilitation and secondary prevention protocols
to prevent recurrent heart attacks.
In addressing the components of an optimal cardiac rehabilitation program, the statement emphasizes
the benefits of exercise-based rehabilitation. It includes a summary of research findings that shows
average cardiac death was 26 percent lower in rehabilitation patients who were exercise-trained
compared with those who received usual care. There were also 21 percent fewer nonfatal heart attacks,
13 percent fewer bypass surgeries and 19 percent fewer angioplasties in the exercise-trained people.
The specific benefits of the exercise training component are improved functional capacity for the patient,
improved blood vessel function, improvement in cardiovascular risk factors, improved coronary blood flow,
improved electrical stability of the heart muscle (thus reducing the risk of a fatal heart rhythm disturbance),
reduced risk of blood clots and reduced cardiac work and oxygen requirements.
The group’s recommendations for areas of future research include evaluating community, home and Internet-based
interventions and care management by non-physician health care professionals to complement the physician’s services.
The group also said that future research should include comparing the cost-effectiveness of traditional
supervised programs versus these alternative interventions related to improving patients’ functional capacity,
self-efficacy, independent living, risk factor modification, long-term use of therapy, re-hospitalization rates
and quality of life.
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