Heart disease remains the leading cause of death in the United States, claiming nearly 700,000 lives each year. Many of these are due to secondary coronary events: heart attack, stroke, or heart failure following a previous adverse coronary event. But with proper cardiac rehabilitation, which can reduce risk of death by as much as 47%, many of those could likely have been avoided.

However, according to some of the latest studies from the American Heart Association and the CDC, it’s possible that as few as 19% of those eligible for cardiac rehab are taking advantage of these life-saving programs.

At Sarasota Memorial, our Cardiopulmonary Rehabilitation Program provides individualized treatment designed to improve cardiovascular health and quality of life, empowering patients to lead active and productive lives. And healthcare professionals like Meredith Cleveland, BS, CCRP, ACSM/NPAS, Supervisor of Cardiopulmonary Rehabilitation Services at Sarasota Memorial, are spreading the word.

"Because if you don't make real lifestyle changes, it isn't something that's just going to go away because of a stent or surgery," Cleveland says. "Those are Band-Aids, not a complete fix."

Why Choose Cardiac Rehab?

"The primary goal of cardiac rehab is for patients to understand that they need to make serious lifestyle changes in order to prevent anything moving forward," says Cleveland. "And that, with intensive lifestyle modifications, they can even reverse heart disease too."

These lifestyle changes can be broken down into three areas of improvement: exercise, diet, and stress management. During the 12-15 week program, cardiac rehab specialists are available to help with all three, creating individualized approaches for every patient, every session.

Studies from the American Heart Association, the CDC and the Centers for Medicare and Medicaid have shown strong and consistent evidence that cardiac rehab results in:

• Fewer cardiac events
• Fewer hospital readmissions
• Higher rate of continued employment
• Lower healthcare costs
• Greatly reduced risk of premature death.

Beyond that, Cleveland has seen firsthand what it can do for a person's mental wellbeing, when they take control of their health and their future. "We see huge improvements in both their quality-of-life scores and their depression scores," she says.

But still, far too few of those eligible take advantage of the cardiac rehab resources available to them.

EXERCISE for CARDIAC REHAB

The program begins with an initial evaluation. Together with a certified exercise physiologist, patients discuss exercise goals and address any questions or concerns. An exercise tolerance test (typically on a treadmill) sets a baseline and starting point for improvement.

In the following weeks and months, sessions will be spent building cardiac strength and exercise endurance through the use of treadmills, recumbent bicycles, recumbent stair-steppers and more, depending on what is most safe, comfortable and effective. Participants will also engage in strength training, which compounds the effects of standard cardio to provide the best results for cardiovascular fitness.

Every 30 days, progress and goals are reviewed, and any adjustments can be made, so patients get the most out of their time at rehab.

By the program’s conclusion, patients are equipped with the know-how to exercise safely and effectively, along with a personalized home exercise program to keep them on track for good.

"Ideally, we don't want to see them again," Cleveland says with a laugh. "So it's all about building them up to where they feel comfortable exercising on their own and maintaining their cardiac health."

DIET & NUTRITION for CARDIAC REHAB

There's an old saying in the nutrition and exercise world: "You can't outrun a bad diet." The same applies to cardiac rehab.

In addition to learning the best exercises for them, cardiac rehab participants also learn how to build a heart-healthy diet that works for their lifestyle. "Some patients are already exercising," says Cleveland, "but the diet is an issue. We give them as much nutrition education as we can."

Every patient will have their own nutrition assessment, which will help shape their own personal diet plan, but the recommended heart-healthy diet typically consists of the following:

• A heavy emphasis on fruits and vegetables
• An emphasis on whole grains
• Attention to healthy sources of protein, prioritizing nuts and legumes but including fish and seafood, low-fat and fat-free dairy, and limited amounts of lean poultry

While cutting back on or eliminating:

• Processed foods
• Added sugars
• Salt intake
• Alcohol

And no smoking.

STRESS MANAGEMENT for CARDIAC REHAB

It's no secret that stress negatively affects our health in a wide variety of ways. It should be no surprise that this also applies to cardiovascular health.

"Stress management is hugely important," says Cleveland. "A heart attack or open-heart surgery takes its toll physically, but also mentally. There's fear. There's anxiety. We talk about it."

A proactive approach means patients in cardiac rehab will learn about different stress management techniques, so they can find the tools that work for them. In-person instruction is supplemented by take-home materials and directions to online resources, including instructional videos and guided therapies.

Perhaps more importantly, patients in cardiac rehab can build their own social support networks.

“They come in and talk to us,” Cleveland says, “but then they get to talk to other patients and there becomes a sort of camaraderie.”

 

 

Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH's in-house wordsmith, Lederer earned his Master's degree in Public Administration and Political Philosophy from Morehead State University, KY, and can definitely work on that whole "stress" thing.