Benefits of Cardiac Rehabilitation

The most substantial evidence-based benefits of cardiac rehabilitation include an improvement in exercise tolerance, improvement in symptoms, improvement in blood lipid levels, reduction in cigarette smoking, improvement in psychosocial well-being and reduction of stress, and reduction in mortality. These are addressed in turn.

Appropriately prescribed and conducted exercise training is an integral component of cardiac rehabilitation, particularly for patients with decreased exercise tolerance. Specific activity recommendations are available for women, for older adults, for patients with chronic heart failure and after cardiac transplantation, for stroke survivors, and for patients with claudication as a reflection of peripheral arterial disease. Strength training can improve skeletal muscle strength and endurance. Smoking cessation can be achieved by specific strategies. Lipid management requires intensive nutrition education, counseling, and behavioral interventions to improve dietary fat and cholesterol intake. Optimal lipid control typically entails pharmacologic management, in addition to diet and exercise training. Diet and exercise are recommended for weight management. A multifactorial education, counseling, behavioral, and pharmaco-logic approach is the recommended strategy for the management of hypertension. Increased attention is currently directed to management of diabetes and the precise control of other coronary risk factors in diabetic patients. Specific national guidelines address the goals and recommended strategies for lipid management, blood pressure control, management of diabetes, and of obesity and smoking cessation.2-6

Common psychosocial problems in patients referred for cardiac rehabilitation include depression, anger, anxiety disorders, and social isolation. Education, counseling, and/or psychosocial interventions, either alone or as a component of multi-factorial cardiac rehabilitation, can improve psychosocial well-being and quality of life; these are recommended to complement the psychosocial benefits of exercise training. To date, psychosocial interventions have not been documented to alter the prognosis of coronary patients.

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