Referral, Enrollment, and Delivery of Cardiac Rehabilitation/Secondary Prevention Programs at Clinical Centers and Beyond: A Presidential Advisory From the American Heart Association
Open accessAbstract
E ach year, an estimated 785 000 Americans will suffer a new myocardial infarction (MI; heart attack), and nearly 470 000 will have a recurrent attack. 1 Within 5 years of an initial MI, 15% of men and 22% of women 45 to 64 years of age and 22% of men and women Ͼ65 years of age will suffer a recurrent MI or fatal coronary heart disease (CHD). 1 Given this high recurrence rate, preventing secondary cardiac events is an essential part of the care for patients with cardiovascular disease (CVD).Cardiac rehabilitation/secondary prevention programs (CR/SPPs) are medically supervised programs that help patients with CVD to recover more quickly after a cardiac event and to stay healthy.CR/SPPs are more than just diet and exercise programs; these programs offer a multifaceted and multidisciplinary approach to optimize the overall physical, mental, and social functioning of people with CVD.CR/SPPs include specific core components that aim to optimize cardiovascular risk reduction, foster healthy behaviors and compliance with these behaviors, reduce disability, and promote an active lifestyle for patients with CVD. 2 Comprehensive CR/SPPs consist of baseline patient assessment, nutritional counseling, aggressive risk factor management (ie, lipids, hypertension, weight, diabetes mellitus, and smoking), psychosocial and vocational counseling, and physical activity counseling and exercise training.Patients participating in CR/SPPs are also prescribed cardioprotective drugs that have evidence-based efficacy
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Older adults are even less likely to attend phase II CR, particularly those discharged to a skilled nursing facility or to home care services after hospitalization, despite proven benefits.
“Older adults are even less likely to attend,212 particularly those discharged to a skilled nursing facility (SNF) or to home care services after hospitalization,214 despite proven benefits.215,216”
Even when referred, fewer older adults actually enroll; many cite logistic, psychosocial, and financial impediments.
“Furthermore, even when they are referred, fewer older adults actually enroll; many cite logistic, psychosocial, and financial impediments.212”
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- Authors
- Balady, G. J., Ades, P. A., Bittner, V. A., Franklin, B. A., Gordon, N. F., Thomas, R. J., Tomaselli, G. F., & Yancy, C. W.
- ORCID
- Venue
- Circulation
- Published
- 2011-12
- Volume
- 124
- Issue
- 25
- Pages
- 2951-2960
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1988513614
- Cited by
- 607
- References
- 51
- Citations by year
- 2026: 9 · 2025: 35 · 2024: 39 · 2023: 41 · 2022: 51 · 2021: 58 · 2020: 42 · 2019: 54 · 2018: 40 · 2017: 58 · 2016: 43 · 2015: 40 · 2014: 33 · 2013: 40 · 2012: 20
- FWCI
- 20.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- cardiac rehabilitation, secondary prevention, myocardial infarction, referral, program enrollment, program delivery, cardiovascular disease, risk factor control, exercise training, psychosocial counseling, nutrition counseling, reinfarction
- MeSH terms
- American Heart Association, Health Promotion, Heart Diseases, Humans, Referral and Consultation, Rehabilitation Centers, United States, Patient Selection
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