Living Longer With Heart Rehab

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People do better after a heart attack or bypass surgery if they stick with their rehab program, says a study. The study looked at Medicare records for 30,000 people. All of them had been hospitalized for a heart attack, a bypass operation or long-term, severe chest pain. All went to at least one session of a cardiac rehabilitation program. They learned about how to exercise more, eat better and quit smoking. About 11% of people who went to all 36 sessions died in the next three years. About 18% of those who went to fewer than 12 sessions died. People who went to more sessions also were less likely to have a heart attack. The journal Circulation published the study results on December 21.

What Is the Doctor's Reaction?

After having heart surgery or a heart attack, one of the best things you can do for your heart long-term health is to go through a cardiac rehabilitation program.

Such programs have been shown to reduce deaths by up to 25% during the few years following the heart attack or procedure. This most recent study suggests that the reduced death rate might be as high as 50% for those who stick with the full program. That’s at least as good as taking aspirin, a beta blocker, a statin, or a combination of these.

The benefits of cardiac rehabilitation go beyond survival and heart health. These programs improve muscle strength, lung function, and endurance, all of which are essential for returning to an active life after heart surgery or a heart attack.

Yet barely 20% of people who are eligible for cardiac rehabilitation take part in a program. And for those who do sign up, only 18% completed all 36 sessions that were paid for by insurance.

Cardiac rehabilitation programs include:

• Exercise routines designed to fit your personal needs and progress


• Psychological and social support


• Dietary advice and weight loss counseling


• Support to help smokers quit for good


• Stress reduction

What Changes Can I Make Now?

In reality, anyone can sign up for a cardiac rehabilitation program. The catch is that insurers will pay for it only for people who have:

• Undergone heart bypass surgery


• Had a heart attack


• Undergone angioplasty, with or without a stent


• Coronary artery disease and angina (chest pain or other symptoms with physical activity)


• Undergone heart valve surgery


• Undergone a heart or lung transplant

The standard exercise program centers around walking on a treadmill. You start with slow walking on a flat surface. Over time, you increase your speed. Resistance is added by having you walk on an incline. Your exercise therapist monitors your heart rate, blood pressure and oxygen levels.

Once you have reached a comfortable exercise level, you are ready for the maintenance phase. You could increase your exercise intensity, with shorter durations of workouts, about 30 minutes three to four times per week. However, many experts prefer longer workouts, 45 to 60 minutes, every day at a lower intensity level. This program is sometimes referred to as “Walk Often, Walk Far.”

What Can I Expect Looking to the Future?

You can expect to notice more people asking for and doctors ordering cardiac rehab programs.