Assessing the Readability and Quality of Cardiac Rehabilitation Program Websites in Michigan

Abstract

We hypothesized that exercising nonconcordantly along with the addition of CLOCK SNP rs1801260 posed a risk for our participants. The results showed that most participants in CR were attending CR nonconcordantly based on their MEQ scores, which was later confirmed by rs1801260 genotyping. More importantly, the results showed that an interaction existed between nonconcordance and rs1801260, resulting in greater health care utilization. These results confirm previously associated outcomes related to the effects on diurnal patterns and exercise. 3,8 Although the mechanistic pathway for this interaction remains unclear, previous studies support the key role of the CLOCK gene in cardiovascular health. The CLOCK gene encodes proteins on the positive transcription circadian feedback loop. 5,7 Evidence suggests that TC or CC genotypes are associated with higher total cholesterol, hypertension, and increased risk for ACS events. 4,7,10 Experts hypothesize that C carriers have less autonomic nervous system activity compared to TT carriers which may contribute to the increased risk for ACS events especially in the morning hours. 10 Thus, it is hypothesized that adding the physiological stressors associated with exercising nonconcordantly to ACS participants may explain the need for additional health care services.Several limitations exist including small sample size and single setting. Some of the ED visits/hospitalizations may have been related to non-cardiac-related emergencies (ie, trauma). This study advances CR science and provides foundational support for larger studies exploring the effect of CR, CLOCK genes, and hospital utilization.