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Fact Sheets and At–a–Glance Reports
State Heart Disease and Stroke Prevention Program Addresses Cardiac Rehabilitation
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Goals of Cardiac Rehabilitation6
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Improve
functional capacity and quality of life. |
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Reduce risk of
sudden death and subsequent heart attack. |
• |
Ease angina
pectoris symptoms. |
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Prevent
progression of underlying disease. |
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Cardiac Rehabilitation Facts
- Each year about 1 million people survive heart attacks in the
United States.1 Additionally, more than 7 million people
have stable angina, more than 1 million patients have angioplasty, a procedure to unblock coronary arteries, and almost half a million
patients have bypass surgery.1
- All of these persons with heart disease could benefit from cardiac
rehabilitation (rehab).1 The purpose of cardiac rehab is to modify a person's coronary risk factors and to reduce
mortality, morbidity, and functional disability due to cardiovascular
illness.2-4
- In 2001, 19 states and the District of Columbia included
questions in the state-based Behavioral Risk Factor Surveillance System
(BRFSS) survey regarding receipt of cardiac rehab services following a
heart attack.5 The findings indicated that less than a third
of heart disease patients had participated in cardiac rehab even though
most might have benefited from these services.
- Other studies suggest that women who have suffered a recent heart
attack or had bypass surgery are less likely to be referred to or
participate in a cardiac rehab program.6,7 Patients aged 70
years or
older are much less likely to participate in cardiac rehab in comparison
to younger patients.
- Recent research demonstrates that physician referral is the most
powerful predictor for cardiac rehab enrollment.7,8 Clinical
practice guidelines for cardiac rehab were released and widely
disseminated to health professionals in 1995 by the Agency for Health
Care Research and Quality.2
- Comprehensive cardiac rehab has been shown to reduce
re-hospitalization rates, reduce recurrent sudden cardiac death, lessen
the need for cardiac medications, and increase the rate of persons
returning to work.
- Including cardiac rehab in intervention plans for patients with
heart disease remains a key strategy for reducing further disability and
death.
State Heart Disease and Stroke Prevention Programs Take Action
Prevention through medical and public health education is vital for improved
physician referrals and patient enrollment in cardiac rehabilitation.
Examples of activities to implement in health care settings and the
community include the following:
- Promoting health care environments that improve quality of care by
increasing adherence to guidelines for heart attack survivors, persons
with stable angina, and persons with coronary artery disease.
- Potential Partners:
primary care associations, federally-qualified health centers,
managed care organizations, Medicare Quality Improvement Organization,
American Heart Association (AHA), rehabilitation, medical associations,
nursing associations, and healthcare provider associations.
- Promoting policies for diagnostic evaluation to refer
eligible patients to cardiac rehabilitation and appropriate follow-up.
- Potential Partners: hospitals, managed care
organizations, federally-qualified health centers, medical
associations, nursing associations, healthcare provider
associations, and AHA affiliate.
- Strengthening secondary prevention through increased
awareness and education about the benefits of cardiac rehabilitation
that promote heart healthy lifestyles.
- Potential Partners: AHA affiliate, faith– and community–based
organizations, local minority nursing association, and local health
departments.
- Advocating for health care coverage that includes cardiac
rehabilitation services for persons that have coronary artery disease or
have had a previous heart attack.
- Potential Partners: AHA affiliate, business and human
resource management, employee associations, unions, third–party
payers, health care providers, local policymakers.
- Advocating for equality in access to rehabilitation
services for all persons, including women and members of diverse
populations.
- Potential Partners: primary care associations,
federally-qualified health centers, managed care organizations,
Medicare Quality Improvement Organization, American Heart
Association (AHA), rehabilitation and medical associations.
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References
- American Heart Association. Heart Disease and Stroke Statistics—2007 Update. Dallas, TX: American Heart Association; 2007.
- Department of Health and Human Services, Agency for Health Care
Policy and Research (AHCPR). Cardiac Rehabilitation, Clinical
Guidelines. Rockville, MD: AHCPR,1995.
- Recovering from heart problems through cardiac rehabilitation.
Patient guide, Consumer Guide, AHCPR,1995.
- Balady GJ, Fletcher BJ, Froelicher ES, Hartley LH, Krauss RM,
Oberman A, Pollock MK, Taylor CB. Cardiac rehabilitation programs: A
statement for health care professionals from the American Heart
Association. Circulation 1994;90:1602.
- Ayala C, Orenstein D, Neff LJ, Greenlund KJ, Croft JB, Mensah GA
Receipt of cardiac rehabilitation services among persons with heart
attack—19 states and the District of Columbia, Behavioral Risk Factor
Surveillance System, 2001. Morbidity and Mortality Weekly Reports 2003;42:1072–1075.
- American Associate of Cardiovascular and Pulmonary Rehabilitation.
Scientific evidence of the value of cardiac rehabilitation services with
emphasis on patients following myocardial infarction. Section I:
Exercise conditioning component. J Cardiopulm Rehabil 1990;10:79.
- Witt BJ, Jaceobsen SJ, Weston SA, Killian JM, Meverden RA, Allison
TG, Reeder GS, Rover VL. Cardiac rehabilitation after myocardial
infarction in the community. J Am Cardiol 2004:44:988–996.
- Benz Scott LA, Ben-Or K, Allen JK. Why are women missing from
outpatient cardiac rehabilitation programs? A review of multilevel
factors affecting referral, enrollment, and completion. J Women’s
Health 2002;11(9)773–791.
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Date last reviewed:
02/07/2007
Content source: Division for Heart Disease and Stroke
Prevention,
National Center for Chronic Disease Prevention and
Health Promotion |
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