Cardiac Rehab Improves Survival

Heart rate recovery and survival boosted with cardiac rehabilitation

(RxWiki News) Cardiac rehabilitation for heart disease patients doesn't just lower their future risks. Research shows it also helps train the heart to quickly return to a normal rate following exercise, improving their chance of survival.

Cardiovascular disease patients with normal heart rate recovery live longer than those whose hearts recover more slowly because a rapid return to a normal heart rate marks a heart that works better. Heart rate recovery refers to the number of beats the heart rate declines during the first minute after stopping exercising.

"Ask your cardiologist whether you can benefit from cardiac rehabilitation after a heart event."

Dr. Leslie Cho, lead author of the study and director of the Women’s Cardiovascular Center at the Cleveland Clinic, said there is currently no medicine capable of doing that.  She said if a drug existed that could make a dramatic impact in mortality improvement, "it would be the blockbuster drug of the century."

Investigators studied 1,070 patients with various types of heart disease who were referred for cardiac rehabilitation at the Cleveland Clinic.  Patients were supervised by doctors as they exercised about three times each week. Each session included 10 to 15 minutes of warm up and stretching, 30 to 50 minutes of continuous aerobic activity and another 15 to 20 minutes of cool down.

Researchers measured heart rate recovery with an exercise stress test before and after 12 weeks of cardiac rehabilitation. A count of 12 beats or less was considered abnormal.

Of those patients, 544 began cardiac rehabilitation with abnormal heart rate recovery, but 41 percent of those patients had normal heart rate recovery after completing the three-month program. The other 526 patients began the program with normal heart rate recovery, and 89 percent maintained it after completing rehabilitation.

Most of the patients who did not show improvements were patients who were older with a history of diabetes, peripheral artery disease or congestive heart failure. Additional research is underway to determine whether an additional 12 weeks of cardiac rehabilitation could help those patients.

Even after adjustments for factors such as smoking, medications and weight, the risk of dying within eight years was more than doubled in those with abnormal heart rate recovery after completing the program.

Less than 20 percent of patients who are eligible for cardiac rehabilitation actually participate in such programs. Dr. Cho called it one of the most underused treatments in the United States. She said it is not recommended often enough, and when it is, many are not informed that rehabilitation can help them liver longer.

The clinical study was published in Circulation: Journal of the American Heart Association.

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Review Date: 
September 28, 2011