Features February 2010 Issue

Know the 3 Main Reasons You Could Benefit from Cardiac Rehabilitation

Diet, exercise and risk factor reduction are keys to making the most of your recovery.

When most people are first diagnosed with cardiovascular disease (CVD), they are confronted with major lifestyle changes: stop smoking, lose weight, eat better, take medications and exercise.

"There is no doubt that lifestyle modification is difficult, because it takes time, education and support," says Mike Crawford, MS, manager of Cardiac Rehabilitation at Cleveland Clinic. "A good cardiac rehab program provides all of these things. Experts on nutrition, exercise and behavior change will help you understand the CVD process, treatment goals, identify hurdles to your success and help a person find ways to meet their health goals. The rehab staff works closely with each patient, their cardiologist or managing physician."

Those who are eligible for cardiac rehab are people who have had recent heart attacks, stents, coronary artery bypass surgery, valve repair or replacement, chronic angina, or heart and/or lung transplantation.

Gordon Blackburn, PhD, program director for Cardiac Rehabilitation at Cleveland Clinic, adds that bypass surgery, angioplasty or stents are effective strategies to treat advanced heart disease, but they do nothing to prevent or stop the progression of the disease process.

"Heart disease is a progressive condition caused by a variety of factors, many of which can be modified with appropriate medical and/or lifestyle change," he says. "Participants in cardiac rehab have a 25 to 30 percent reduction in risk of death from coronary artery disease. Although this is a covered service by CMS (Medicare), only 15 to 20 percent of patients nationwide enroll in even one session."

While the goals of cardiac rehab are ambitious and far-reaching, the basics of the program are relatively simple to understand. "The only way to reduce the development of cardiovascular disease is to aggressively treat all of the risk factors that lead to CVD," Crawford says. "There are 3 main components: Working closely with your physician to diagnosis, treat and provide therapy to reduce CVD risk factors, diet, and physical activity."

Work With Your Doctor and Rehab Team

While some of the more visible aspects of cardiac rehab include exercise and the monitoring of your vital signs, a key to making sure you remain healthy long after the rehab program ends is the education and counseling you get about medications, risk factor modification and following your doctorís advice.

"Medications can be very confusingówhat are they for, how do I take them, what are side effects, how do I store them, what do I do when I travel?" Crawford says. "The rehab staff can help address questions regarding taking medications. Also the rehab team can relay important information back to your physician regarding how the medications are working. If your blood pressure, blood sugar, heart rhythm, etc. are not at the level the doctor wants, the rehab staff can communicate that to help your doctor make sure you have the right amount or type of medication."

Cardiac rehab patients also learn how to pay better attention to the signals their bodies send, which is important because prompt response to symptoms will help head off emergencies down the road and help adjust medications, exercise routines and more. Changing the dosage or adding a new drug to your daily regimen can lead to side effects, so itís especially important that you donít disregard signs such as pain, headaches, dizziness, shortness of breath and nausea.

"By learning to pick up on what your body is telling you, the better your healthcare provider can help you optimize your health," Crawford says. "This will allow you to be more proactive with your health instead of reactive."

Diet

As part of the lifestyle change youíll learn about in cardiac rehab, starting a more heart-healthy eating plan can be among the toughest challenges many patients will face. But learning how to reduce the fat, cholesterol and sodium in your diet and keep your weight under control, if needed, is critical to long-term cardiovascular health.

"As for nutrition, it can be tricky, as everything that a person eats affects the body," Crawford says. "It may be reflected in cholesterol levels, blood sugar levels, blood pressure and/or a personís body weight."

Exercise

Even if you were fairly active before you started cardiac rehab, youíll need to learn how to approach exercise from the perspective of a heart patient. And if youíve had a sedentary lifestyle, regular exercise may be something altogether new. Itís important to remember that exercise helps burn calories to keep your weight under control and revs up your metabolism so you burn calories more efficiently even when you arenít working out. Regular physical activity also helps strengthen your heart muscle, which is at the very core of your recovery. But it takes guidance to know just how hard to push yourself.

"A cardiac rehab program assists people with exercising with the proper type, frequency, intensity and duration to achieve goals and minimize risk associated with exercise (CV and/or orthopedic complications)," Crawford says. "For specific health conditions there is a wrong and right way to exercise."