Statistics released in 2005 by the American Heart Association report that one in four individuals in the United States has some form of cardiovascular—heart or blood vessel—disease. Each day, nearly 2,600 Americans die from cardiovascular disease; this averages to about one death every 34 seconds. And those who survive their cardiac “event” likely face some major life choices.
As sobering as this statistic may be, equally serious is the fact that the prevalence of cardiovascular disease is increasing, and will likely continue to increase. Two significant reasons for this trend are that today nearly 7 of every 10 U.S. adults is overweight or obese, and physical inactivity is becoming increasingly prevalent.
In cardiovascular disease, along with many diseases, physicians speak of “primary prevention” and “secondary prevention.” Primary prevention refers to avoiding having the disease develop at all. Secondary prevention is attempting to avoid having the disease process—or the need for further treatment of the disease process—resurface following initial treatment.
A recent article from Circulation (a publication of the American Heart Association), notes that, “Secondary prevention is an essential part of the contemporary care of the patient with cardiovascular disease.” For many individuals, one of the most effective means of beginning this process of secondary prevention is participation in a formal cardiac rehabilitation program following a cardiac incident. Participation in an organized, structured cardiac rehabilitation program following the cardiac event may assist with lifestyle modifications necessary to reduce the likelihood of future cardiac events. Other benefits of cardiac rehabilitation are that it provides an opportunity for close observation and monitoring of the client during the early stages of recovery, when some complications become evident, and that the regular interaction with the cardiac rehab staff and clients who are going through similar “life events” provides psychological and emotional support—camaraderie.
Cardiac rehabilitation programs began in the late 1970s and early 1980s as exercise programs for individuals with recent heart attacks or coronary artery bypass surgery. Over the years, programs like the one at Mount Nittany Medical Center, which started in April 1989, have evolved to include evaluation to help identify the individual client’s risk factors for cardiovascular disease, and education and counseling on means to modify these risk factors to avoid future events. In addition, when appropriate these programs also may include means to help the individual adapt to any limitations resulting from the initial cardiac incident.
To quote the Circulation article, “Improved fitness enhances a patient’s quality of life.” The patient may see this improvement in fitness as less fatigue or fewer symptoms with such activities as carrying groceries, shopping, other activities of daily living, or performing work-related tasks. Studies actually suggest that improvement in fitness actually translates to a reduction in risk of future cardiovascular events, likely owing in part to the fact that the heart and other muscles of the body work more “efficiently,” thus placing less stress on the heart. It’s interesting to note that while the majority of clients of organized cardiac rehab programs show improvement in general conditioning and ability to perform activities of daily living, those who note the greatest improvement are often those who enter the program with the most significant limitations.
Ideally we would all be able to manage our risk factors for cardiovascular disease to avoid developing the problems that go along with it—angina, heart attack, claudication, or the need for heart surgery or angioplasty. Unfortunately, for millions each year this is not the case. Then the emphasis must switch to secondary prevention—risk factor modification to avoid a future event. This is when participation in an organized cardiac rehab program may be of greatest value: its combination of supervised activity, education, and counseling can provide a jumpstart toward the fullest recovery possible and more productive years, as life moves forward.
Gary Neidrick is the Director of Cardiopulmonary Services at Mount Nittany Medical Center. For more information on the cardiac rehabilitation program at Mount Nittany Medical Center, telephone the program at 234-6705.