Most people fear heart disease — and with good reason: it’s the leading cause of death for both men and women. But something that people may not realize is that preventing this disease is often within their control.
Most people who develop heart disease — at least 8 in every 10 — have one or more major risk factors that are within their power to change. These include lack of exercise, high blood pressure, and abnormal cholesterol levels. There are surefire ways to tackle these risk factors that you can include in your daily life. This Special Health Report, Diagnosis: Coronary Artery Disease, describes in detail these strategies and shows you how to keep your heart and arteries healthy for years to come.
It also includes a risk calculator to help predict your odds of developing heart disease over a 10-year period, descriptions of what to expect from various diagnostic tests and procedures for heart problems, and a detailed guide to medications for the heart. And the special section describes lifestyle habits that can help your heart stay healthy.
Whether you or someone you love has heart disease or you’re looking to prevent it, Diagnosis: Coronary Artery Disease, can help.
Prepared by the editors of Harvard Health Publications in consultation Peter H. Stone, M.D., Professor of Medicine at Harvard Medical School, Senior Physcian at Brigham and Women's Hosptial and Director of Vasular Profiling Research Group at Brigham and Women’s Hospital. 53 pages. (2013)
Healing your heart: Cardiac rehabilitation
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. But before you spend your day resting, keep in mind that 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.
What is cardiac rehab?
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.
Depending on your condition, private insurers or Medicare may cover the cost. People usually come to the facility at least once a week, and up to three times a week, and stay from one to several hours. Some people attend for just a few weeks, while others continue for months.
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. Doctors sometimes overlook the importance of referring their patients to cardiac rehab, so ask your physician if rehab is right for you and about local facilities.
Choosing a facility
First, check to see that the program is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). There are about 2,600 cardiac rehab centers nationwide, and about 1,400 have been certified by the AACVPR. The following list of questions can help you decide on a facility:
- Does the staff include trained cardiac nurses, exercise specialists, dietitians, and mental health specialists?
- Is there a doctor on the premises?
- Is the staff ratio at least one to every four patients
- Is the staff certified in basic and advanced life support skills?
- Does the program offer counseling?
- Are assessments and treatment plans individualized?
- Will someone on staff file your insurance claim?
- Will the staff stay in regular contact with your cardiologist?
- Is there a post-rehab program available that would allow you to continue to exercise at the facility for a fee?
While visiting a facility, look for these features:
- A variety of exercise equipment such as treadmills, elliptical trainers, stationary bikes, and step machines
- Equipment that’s modified for elderly or disabled patients
- Free weights, wall pulleys, and rowing machines.