Features December 2013 Issue

Apply the Lessons of Cardiac Rehab to Your Everyday Life

Even if you’re not in a formal program, you can still benefit from the philosophies of cardiac rehabilitation.

You’ve no doubt heard about the benefits of cardiac rehab for individuals who have had heart surgery or undergone angioplasty. But the lessons rehab patients learn about exercise and lifestyle changes can help those who are hoping to avoid heart disease and any needed interventions.

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Learning how to exercise at the right intensity level is a key component of cardiac rehab.

“The exercise recommendations for general health are very similar to those of people in cardiac rehab,” says Michael Crawford, Manager of the Cleveland Clinic Cardiac Rehabilitation Program. He adds, however, that a consistent exercise routine is only part of the overall approach to cardiovascular health that is conveyed in cardiac rehab.

What is cardiac rehab?
Cardiac rehabilitation usually is prescribed for patients who have had a heart attack or undergone coronary artery bypass graft surgery, heart valve replacement or repair, angioplasty with or without stenting, or who have chronic angina, Crawford explains.

The first phase of cardiac rehab is usually 12 weeks long and includes 36 outpatient sessions that include supervised exercise and lessons about medication adherence, diet and other lifestyle behaviors. A subsequent Phase 2 program may be recommended if a patient’s doctor believes it’s necessary.

“Some cardiac rehab programs offer a maintenance program called phase 3 and phase 4, and they may accept patients into these programs with diagnoses such as high blood pressure, high cholesterol, diabetes, obesity or a family history of coronary artery disease,” Crawford says. “These programs can provide direction and accountability for patients who need structure or motivation for their lifestyle changes. Phase 3 and 4 cardiac rehab are self-pay, but are usually kept at a low cost.”

What you need to know
But if you’re not in any program, you can still approach your heart health with the same kind of motivation and structured approach as you would if you were in cardiac rehab. “To keep your heart healthy after a procedure, it is important to remember that there must be a balance between exercise, nutrition and medications to reach your goal numbers for cholesterol, blood pressure, diabetes and weight,” Crawford says. “Each element will affect the body in some way, and any change in the routine will alter the numbers. If one of the three is not being addressed, that means there needs to be more emphasis on the others. The ultimate goal is to control the risk factors that lead to heart disease, and this can be accomplished in a number of different ways.”

While your particular medication regimen will be tailored to your individual needs, advice for diet and exercise is a little more general. Most heart experts recommend a

Mediterranean-style eating plan or the DASH (Dietary Approaches to Stop Hypertension) diet, both of which focus on fruits, vegetables, whole grains, low- or non-fat dairy, and little or no red meat.

And when it comes to exercise, there is also general consensus on what’s best to keep a heart healthy, though Crawford stresses that the intensity of an activity can vary greatly depending on the condition of the individual. He says the standard rule of thumb still applies—that you should be able to talk with someone while you’re exercising, but be working hard enough that you couldn’t sing to them.

“Exercise should be done on most days of the week for 30 to 60 minutes each day,” Crawford says. “A well-rounded exercise program has cardio, strength, flexibility and balance training.”

If you’re not in a cardiac rehab program, but you want to simulate your own, consider working with a personal trainer or physical therapist familiar with the needs and limitations of someone with heart disease risk factors.

Crawford also notes that a great benefit of cardiac rehab is the social support that comes from being around others facing similar challenges. “If a person cannot complete cardiac rehab, they may have other resources in their community, such as support groups that provide that same feeling,” he says. “Finding a person who will help support you in your efforts is a big help.”

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