Cardiac rehabilitation

Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
American family physician (Impact Factor: 2.18). 11/2009; 80(9):955-9; hand-out 960.
Source: PubMed


An estimated 80 million (nearly one in three) Americans have cardiovascular disease, which is the leading cause of morbidity and mortality worldwide. In the United States alone, more than 850,000 deaths are attributed annually to cardiovascular disease, and more than 8 million Americans have had a heart attack. Nearly 7 million cardiovascular procedures are performed annually in U.S. hospitals. Cardiac rehabilitation is a comprehensive program of patient evaluation, risk factor reduction (e.g., lipid control, weight management), physical activity, and longitudinal care designed to reduce the effects of cardiovascular disease, and is an effective means of mitigating disease and disability. Family physicians incorporate many of the fundamental principles of comprehensive cardiac rehabilitation into their daily practices. However, the use of dedicated cardiac rehabilitation programs serves to further reinforce the principles of nutrition, physical activity, risk factor reduction, and wellness. Cardiac rehabilitation services are underused in the United States, even though there is evidence that structured programs improve quality of life and reduce mortality for patients with coronary artery disease and other select forms of cardiovascular disease.

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    • "On the other hand, this difference may be due to complex, multidimensional, and dynamic structure, and subjective nature of QOL. Findings of a review study showed that the effects of exercise-based rehabilitation programs in terms of overall reduction in adverse clinical outcomes are similar to those of comprehensive cardiac rehabilitation programs after myocardial infarction.[24] "
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    ABSTRACT: Cardiac syndrome X is a relatively common disorder, and still not much is known about the causative factors or its pathophysiology, which makes it difficult to cure. Due to its chronic nature and debilitating symptoms, many patients have significantly reduced quality of life (QOL).The purpose of this study was to assess the impact of phase III cardiac rehabilitation (CR) and relaxation on the QOL of patients. This research is a randomized clinical trial study. Forty eligible and consenting women (age 30-65 years) were randomly assigned to four groups. In the first group (n = 11), progressive muscle relaxation (PMR); in the second group (n = 11), phase III CR; and in the third group (n = 11), PMR along with phase III CR were performed for 8 weeks at home. The fourth group (n = 7) was used as the control group. Short form of QOL questionnaire (SF-36) was used for data gathering. Data analysis was performed using χ(2), Kruskal-Wallis, and rank sum difference tests. After phase III CR, relaxation, and combination of CR and relaxation, patients demonstrated improved QOL (P < 0.001). The results of post-test multiple comparisons showed that there were statistically significant differences between control and all intervention groups (P < 0.05). There was also statistically significant difference between relaxation and combination of phase III CR and relaxation groups (P < 0.5). An 8-week phase III CR program together with relaxation improved QOL of patients with cardiac syndrome X. We suggest phase III CR program together with relaxation as an effective treatment in these patients.
    Iranian journal of nursing and midwifery research 11/2012; 17(7):547-52.
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    04/2012; 12(30):17-25. DOI:10.15600/2238-1244/sr.v12n30p17-25
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    ABSTRACT: Purpose: Cardiac rehabilitation (CR) has been shown to generally increase functional capacity and lower cardiovascular morbidity in patients with ischemic heart disease. The effectiveness of CR in female participants, however, is unclear. We thus examined whether improvement in functional capacity after CR differs between men and women with ischemic heart disease. Methods: Our study was a retrospective cohort study that included 1104 participants (346 women and 758 men) enrolled in CR from 2002 through 2011. We measured change in metabolic equivalents (METs) after CR to assess improvement in functional capacity in male and female participants. We considered various potential confounders, including baseline METs, CR referral indication, age, race, body mass index, baseline cholesterol, and home zip code average prosperity. Results: Men experienced a greater improvement in METs following CR in all models, including the unadjusted model (2.16 METs in men, 1.65 METs in women; P = .0001), the model adjusting for CR indication only (2.15 METs in men, 1.67 METs in women; P = .0003), and the model adjusting for age, body mass index, and CR indication (2.12 METs in men, 1.66 METs in women; P = .0004). Conclusions: We show that men obtain greater benefit from current CR programs than do women. This implies that tailoring CR programs to women may yield further improvement in functional capacity for female CR participants.
    Journal of cardiopulmonary rehabilitation and prevention 07/2014; 34(4):255-262. DOI:10.1097/HCR.0000000000000066 · 1.58 Impact Factor
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