27 August 2020

All cardiovascular patients can benefit from participation in a cardiac rehabilitation program. People who participate in a program, in which they gain more knowledge about risk factors for cardiovascular disease and receive advice about lifestyle and stress management, live longer on average. This observation was made by Radboud university medical center researchers in collaboration with healthcare insurer VGZ. The results have now been published in JAMA Network Open.
 
The research shows that only 31% of people who were diagnosed with a new cardiovascular disorder or who underwent heart surgery between 2012 and 2017 participated in a cardiac rehabilitation program. These are people who suffer from chronic heart failure, have had a heart attack, have a stent, and so on. 

No difference in age or gender

Subsequently, the risk of premature death decreased by 32% for this group when compared to patients who did not participate in cardiac rehabilitation. Remarkably, no differences were found in gender, age, socio-economic status, or the presence of any other disorders. Thijs Eijsvogels, exercise physiologist at Radboudumc: “As it turns out, it makes no difference whether someone is over 80 or under 50, and the presence of any other disorders doesn’t matter either. We saw a positive impact on everyone who participated in a cardiac rehabilitation program.”

Stress management and quitting smoking

Cardiac rehabilitation programs take 6–12 weeks on average, and take place at the hospital or a rehabilitation center. The program consists of informative meetings about the risks and effects of a cardiac disorder, healthy food, and the use of medication. Patients also receive active support for quitting smoking, adopting an active lifestyle, etc. Psychological support and dealing with stress may also be included in the program.

Improved information

VGZ researcher Martijn Maessen: “On the basis of anonymized data we have observed that two-thirds of cardiac patients with an indication for cardiac rehabilitation do not participate. There is a lot to be gained now that we know that participation in the program has a positive effect on life expectancy, for example, by improving the information about the health advantages of cardiac rehabilitation.”

Programs stopped during the coronavirus outbreak

In March and April, nearly all cardiac rehabilitation programs were halted to prevent the spread of the coronavirus. Now they are carefully being resumed. Thijs Eijsvogels: “This research shows that cardiac rehabilitation has a positive effect on the life expectancy of people with cardiovascular disorders. It would be good to avoid having to stop the program again if there is a spike in coronavirus cases, because it means that the number of participants decreases. Rehabilitation at home in conjunction with digital and in-person meetings is the way forward.”
 
Publication in JAMA Network Open
Association of Cardiac Rehabilitation With All-Cause Mortality Among Patients With Cardiovascular Disease in the Netherlands – Thijs M.H. Eijsvogels, Martijn F.H. Maessen, Esmée A. Bakker, Esther P. Meindersma, Niels van Gorp, Nicole Pijnenburg, Paul D. Thompson, Maria T.E. Hopman.
 
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