In 2005, the American Heart Association said that physicians should aggressively encourage patients to enter cardiac rehab programs. "Cardiac rehabilitation programs remain underused in this country, with only 10 to 20 percent of the 2 million eligible patients a year who experienced heart attack or underwent cardiac revascularization procedures participating," said Arthur Leon, M.D., chairman of the writing group and Henry L. Taylor professor in exercise science and health enhancement at the University of Minnesota in Minneapolis.
"In addition to a low physician referral rate, factors contributing to the under use of the services include poor patient motivation and inadequate third-party reimbursement. We need to motivate physicians to be more progressive in educating and referring patients to cardiac rehabilitation programs and motivate insurance companies to cover them." It was noted that research had found average cardiac death was 26 percent lower in rehabilitation patients who were exercise-trained compared with those who received "usual care." There were also 21 percent fewer nonfatal heart attacks, 13 percent fewer bypass surgeries and 19 percent fewer angioplasties in the exercise-trained people.
Leon said the specific benefits of the exercise training component are improved functional capacity for the patient, improved blood vessel function, improvement in cardiovascular risk factors, improved coronary blood flow, improved electrical stability of the heart muscle (thus reducing the risk of a fatal heart rhythm disturbance), reduced risk of blood clots and reduced cardiac work and oxygen requirements.
In 2006, a Johns Hopkins University article reported: "A recent analysis examined the findings from 63 studies of cardiac rehabilitation programs that involved more than 21,000 survivors of a heart attack. The results showed that participation in a cardiac rehab program reduced the likelihood of having a second heart attack within the next year by 17 percent; 2 years after the heart attack total mortality decreased by nearly 50 percent."
In 2007, it was reported that research at the Ochsner Medical Center, New Orleans, Louisiana found that the prevalence of depression decreased a significant 63 percent, from 17 percent to 6 percent, following rehabilitation. And depressed patients who completed cardiac rehabilitation had a nearly 4-fold decrease in mortality compared with depressed patients who did not complete cardiac rehabilitation (30 percent versus 8 percent). They looked at 522 patients with coronary artery disease who were an average of 64 years old and these were compared with a control group of 179 coronary artery disease patients who did not complete rehabilitation.
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