The study of 1,821 patients from Olmsted County, Minn., who had heart attacks between 1982 and 1998 and survived to go home from the hospital, found that nearly half (48 percent) of the deaths within three years of hospital discharge were attributable to not participating in cardiac rehabilitation.
“On average, for patients who participated in cardiac rehab, it was almost as if the heart attack never had happened. They had the same three-year survival as what would be expected from area residents of the same age and sex who had not suffered heart attacks,” says Veronique Roger, M.D., the Mayo Clinic cardiologist who led the study. “Increased participation in cardiac rehabilitation could lead to improved survival among a large proportion of heart attack patients.”
Cardiac rehabilitation is a medically supervised exercise program that helps patients regain strength after a heart attack, bypass surgery or angioplasty. Olmsted County’s cardiac rehab participation is higher than the national average, so this study highlights the significant potential nationwide for improving survival if more patients get into exercise programs.
Women tend to have their heart attacks at older ages, and both women and elderly patients in the study had more accompanying illnesses that made exercise more difficult. But Dr. Roger says women still were less likely to participate in cardiac rehab, even after taking these factors into account.
“Our study was not designed to answer exactly why some groups are less likely to participate, but some key issues for women may be a lack of transportation and support networks,” says Dr. Roger. “They may not see rehab as important, or they may need to care for a spouse who may also be ill.
“Hopefully this study will encourage physicians to give all of their patients, but especially women, that extra nudge to participate in rehab. And for patients, hopefully it will encourage them to follow their doctor’s advice. There needs to be a partnership between the patient and the physician. Participation in cardiac rehab is one very important element of an effective treatment plan,” Dr. Roger concludes.
Other authors of the paper include Brandi Witt, M.D.; Steven Jacobsen, M.D., Ph.D; Susan Weston; Jill Killian; Ryan Meverden; Thomas Allison, Ph.D.; and Guy Reeder, M.D.