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If you follow the news about heart disease closely, it’s easy to be overwhelmed or confused about what puts you at risk and how you can protect yourself. This report helps you identify the risk factors you can control, which range from medical conditions such as high blood pressure to lifestyle choices such as an unhealthy diet or lack of exercise. You’ll learn about the steps you can take to eliminate or at least manage these risks. A Special Bonus Section on cardiac rehabilitation explains what to expect from these heart-healing programs, which can reduce deaths by up to 25% during the years following a heart attack or heart procedure. This report also describes the latest improvements in diagnosis and treatment—including medications and surgical procedures—so that you are aware of your options and can talk with your doctor about them.
Prepared by the editors of Harvard Health Publications in consultation with Thomas H. Lee, M.D., Professor of Medicine, Harvard Medical School, and Harvey B. Simon, M.D., Associate Professor of Medicine, Harvard Medical School. 61 pages. (2009)
Right after having a heart attack or undergoing angioplasty or bypass surgery, you’ll need time to recuperate. In addition to the emotional impact of a brush with mortality, you’ll feel run-down and physically depleted. Even short periods of bed rest and inactivity weaken the muscles, heart, and lungs. Blood loss from surgery, angioplasty, and multiple blood tests can leave you with low blood levels of iron (anemia), a common cause of fatigue. Your appetite may have flagged, and not eating and drinking saps your energy. Finally, your body may be adjusting to a new regimen of medications, which can also cause weakness.
Not that long ago, rest was what the doctor ordered after a heart attack or heart trouble. Taking it easy, the thinking went, wouldn’t stress the heart and would help it heal more quickly. Now, doctors know that inactivity doesn’t help your heart or the rest of your body. Exercise not only strengthens your heart, it helps your muscles use oxygen more efficiently, easing the heart’s workload.
A month or so after a heart attack or bypass surgery, and sooner after angioplasty, you should start cardiac rehabilitation, a medically supervised program designed to help you heal your heart and keep it healthy. The centerpiece of cardiac rehabilitation is usually a structured and supervised exercise program. Rehab programs also teach people about heart disease and how to manage it. Many also offer classes or information on weight management, nutrition education, stress reduction, smoking cessation, and returning to work. The staff typically includes doctors, nurses, exercise specialists, physical and occupational therapists, nutritionists, and psychologists. This special section explains why and how to choose a rehabilitation program and outlines some of the practical information you’re likely to receive. It also features a profile of a physician’s successful recovery following bypass surgery and cardiac rehabilitation.
Cardiac rehabilitation programs have been shown to reduce deaths by up to 25% during the few years following the heart attack or procedure. That’s at least as good as taking aspirin, a beta blocker, a statin, or a combination of these. Participating in rehab can also improve your quality of life. For one thing, you’ll have peace of mind when you exercise, knowing that you’ll be closely monitored for any potential problems. Some people also enjoy the shared camaraderie of working out with people who understand what they’ve been through. Others benefit from group sessions or classes (whether focused on nutrition or relaxation), where they’re able to ask questions and learn from one another. Some rehab programs also offer support groups for family members, who may benefit from personal sharing, as well.
Doctors sometimes overlook the importance of referring their patients to cardiac rehab, so if you qualify, ask your physician about local facilities. Despite the benefits, fewer than 30% of eligible patients take part in rehab. For people 65 and older, participation is even lower—just 14%. A shortage of programs nationwide and accessibility issues (for instance, some facilities aren’t near public transportation or the classes are at inconvenient times) may explain these low figures. Private insurers or Medicare usually cover the cost, although you may have a copayment. Schedules vary among different programs, but people usually come to the facility at least once a week and up to three times a week, from one to several hours. Some people attend for just a few weeks, while others continue for months.
