Dear Doctor Column, May 5, 2008

Cardiac Rehabilitation Improves Quality of Life

Question:

I'm a 65-year-old woman and I've just had a heart attack. My doctor recommends cardiac rehabilitation. I already understand the importance and eating right and staying active, and I'm not sure this type of program has anything to offer me. Is cardiac rehab really worth the time and effort?

Answer:

Yes, definitely! Cardiac rehabilitation, a medically supervised, customized program of exercise and education, offers many benefits to people who have recently suffered a heart attack or who have another heart condition, according to the American Heart Association. Although you already understand the components of a healthy lifestyle, cardiac rehabilitation can help you bring them together to adjust to life after a heart attack, reducing your chances of future heart problems, helping prevent existing conditions from getting worse, and improving your endurance, strength, and ability to maintain normal activities.

As a woman, you have special cause for concern: Heart attacks cause more disability in women than they do in men, and women also are more likely to suffer a second event or die. About 35% of women have a second heart attack within 6 years of their first event, compared with 18% of men. Participating in cardiac rehab significantly reduces your chances of both disability and death.

In the past, cardiac rehabilitation was often reserved for younger people who needed to return to work quickly, but Americans are living longer, more vigorous lives and these programs can improve your ability to stay active and healthy for many years. Cardiac rehab can also help you recover more quickly than you would on your own and address some of the emotional issues that come with living with a heart condition.

Cardiac rehabilitation programs include:

• A comprehensive medical evaluation by a team of health care professionals, including cardiologists, dietitians, exercise rehabilitation specialists, occupational therapists, and psychologists, who will assess your physical condition and create a tailored program aimed at providing you with the safest and swiftest recovery possible. Your plan will focus on reducing or eliminating risk factors that contribute to heart disease, such as high blood pressure and cholesterol, smoking, and physical inactivity.
• Regular monitoring. The team will regularly check your heart rate, blood pressure, and other measures and adjust your treatment program accordingly.
• An exercise plan to build up cardiovascular fitness. Although working out may be the last thing you feel like doing, walking, jogging, and other types of endurance exercise can improve overall functioning and reduce the likelihood of a second heart attack. Your cardiac rehab team will pinpoint the best level of exercise for you, allowing you to start slowly and build strength.
• Lifestyle tips on nutrition, weight loss, quitting smoking, and managing fatigue and pain. Most programs also offer education about specific heart conditions, and provide a forum for you to ask questions about your medications and other important issues such as resuming sexual activity.
• Emotional and social support that can help you cope with issues common after a heart attack — depression, anxiety, and isolation. Counseling can help you cope with these problems more effectively than you can on your own.

Cardiac rehab can help people who have:

• recently had a heart attack, coronary artery bypass surgery, valve replacement, or balloon angioplasty
  
• coronary artery disease
  
• heart failure
  
• cardiomyopathy
  
• angina pectoris (pain from clogged heart arteries)
  
• certain congenital heart diseases
  

Source: American Heart Association

Cardiac rehabilitation can begin while you're still in the hospital and continue with regular sessions designed specifically for you at a medical or community center for up to a year, or even longer if you have special health concerns. Many insurance carriers and Medicare cover cardiac rehabilitation.

Cardiac rehabilitation may seem like a lot of effort, but the payoff is worth it — these programs can help you live a longer, more active life. Ask your doctor to refer you to a program as soon as possible. For more information on heart disease, visit the American Heart Association site.