Effectiveness of nonpharmacological secondary prevention of coronary heart disease

Müller‐Riemenschneider, Falk; Meinhard, Charlotte; Damm, Kathrin; Vauth, Christoph; Bockelbrink, Angelina; Greiner, Wolfgang; Willich, Stefan N.

doi:10.1097/hjr.0b013e32833a1c95

Cited by 54 publications

(43 citation statements)

References 59 publications

(120 reference statements)

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“…Therefore, it is of crucial importance that new therapeutic strategies are not only aimed at improving the health status of cardiovascular patients but also at prevention of future cardiac events and hospitalisation. As such, exercise-based cardiac rehabilitation (ECR) after an acute coronary syndrome (ACS), coronary revascularisation and in patients with chronic heart failure (CHF) has been shown to be a highly effective treatment, improving exercise capacity and quality of life, while reducing the risk of recurrent cardiovascular events and mortality [3,4]. Therefore, exercise training in these patients is now recommended in both national and international guidelines [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Exercise training programs in Dutch cardiac rehabilitation centres

et al. 2013

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Purpose To assess methods for determination of exercise intensity, and to investigate practice variation with respect to the contents, volume and intensity of exercise training programs in Dutch cardiac rehabilitation (CR) centres. Methods A paper questionnaire was sent to all Dutch CR centres, consisting of 85 questions for patients with an acute coronary syndrome (ACS) or after coronary revascularisation (Group 1) and for patients with chronic heart failure (CHF, Group 2). Results CR professionals from 45 centres completed the questionnaires (58 %). Symptom-limited exercise testing was used to determine exercise capacity in 76 % and 64 % of the CR centres in group 1 and group 2, respectively; in these centres, a percentage of the maximum heart rate was the most frequently used exercise parameter (65 % and 56 %, respectively). All CR centres applied aerobic training and the majority applied strength training (64 % in group 1 and 92 % in group 2, respectively). There was a considerable variation in training intensity for both aerobic and strength training, as well as in training volume (1-20 h and 1-18 h respectively).

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Section: Introductionmentioning

confidence: 99%

Exercise training programs in Dutch cardiac rehabilitation centres

et al. 2013

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“…A Cochrane review reported a 27% (odds ratio [OR]: 0.73; 95% confidence interval [CI]: 0.54 to 0.98) reduction in total mortality and 19% reduction (OR: 0.81; 95% CI: 0.65 to 1.01) in total mortality and non-fatal cardiac events with exercise-only CR, with slightly lower but comparable effects of comprehensive CR [5]. More recent meta-analyses suggest even stronger effect, with halving of mortality for any type of CR [6]. CR programs compare favorably to effective pharmacological treatments for secondary prevention of CVD (e.g.…”

Section: Definition and Indications Of Cardiac Rehabilitationmentioning

confidence: 99%

“…statins and beta-blockers). Among its component interventions, evidence suggest that exercise may have a stronger effect on mortality, while psychological interventions act more on quality of life measures; evidence on the other component of CR or the nature of exercise that produce the most benefit is limited [6].…”

Section: Definition and Indications Of Cardiac Rehabilitationmentioning

confidence: 99%

Joga i rehabilitacja kardiologiczna (Yoga-CaRe) u osób po przebyciu ostrego epizodu wieńcowego

et al. 2017

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Cardiovascular diseases are a leading cause of death and disability in Asian Indians with huge psychological and economic impact as it affects population in thirty-and forty-year-olds, previously healthy adults and most productive social group. Successful transcatheter therapeutics has opened a new vista for its management; however, it cannot prevent its recurrence. Therefore, secondary prevention is cornerstone of management. Yoga-based Cardiac Rehabilitation (Yoga-CaRe) is a multifaceted approach targeting patient's physical, psychological, social and occupational status, preventing or delaying the progression of underlying disease and reducing the risk of recurrent rehospitalization and death as well as enabling the patients to live a comfortable and active life. Yoga is an ancient Indian system of philosophy; a mind-body discipline encompassing an array of philosophical precepts, mental attitudes and physical practice. Of seven major branches of yoga, Hatha yoga, which itself includes many different styles (e.g. Iyenger, Ashtanga, etc.), is probably the most commonly recognized, and incorporates elements of physical poses, breath control and meditation, and self-restraint (including that of diet, smoking, alcohol intake and sleep patterns). A Cochrane review reported a 27% reduction in total mortality and 19% reduction in total mortality and non-fatal cardiac events with cardiac rehabilitation (CR), comparing favorably to effective pharmacological treatments (e.g. antiplatelets, angiotensin-converting enzyme inhibitors, statins and beta-blockers). Yoga, therefore, could provide a useful frame work on which to develop an economical CR program, with additional advantages of being culturally appropriate to Indians and potentially be appealing to global population.

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“…40,41 In addition, psychological interventions do appear to be effective in reducing both depression and anxiety. Psychological interventions were also found to be most effective in reducing depression when they included an intent to treat type-A behaviors; however, interventions focusing on a) education about cardiac risk factors, b) emotional support through client discussion and c) included family members in the treatment process were significantly less effective in affecting depression.…”

Section: Psychosocial Interventionmentioning

confidence: 99%

Importance of psychosocial status in secondary prevention and rehabilitation of coronary artery disease

McCormick¹

2011

Srce i krvni sudovi

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Introduction The rehabilitation and secondary prevention of coronary heart disease (CHD) has increasingly acknowledged the effect of psychosocial factors in disease progression. Although psychosocial factors have been recognized as relevant to cardiac rehabilitation for over 30 years, 1 calls for greater attention to psychosocial status in CHD onset and rehabilitation only began appearing in professional literature in the mid to late 1990s. 2,3 At present knowledge of psychosocial factors in CHD are considered core competencies for all professionals working in cardiac rehabilitation and secondary prevention. 4 This paper reviews recent research in psychosocial risk factors for CHD as well as implications for rehabilitation and secondary prevention. In addition, motivation and readiness for change are reviewed as a critical consideration in behavioral change as part of both rehabilitation and secondary prevention. Psychosocial risk factors LifestyleLifestyle and behavior represent one of the most directly modifiable factors in secondary prevention of CHD. 5Principal among these risk factors are elevated cholesterol and triglycerides, obesity, high blood pressure, smoking, diabetes and sedentary behavior, and current guidelines for secondary prevention suggest treatment in all areas.6 Although these risk factors are appropriately considered as biophysical factors, there is evidence that changes in these biophysical factors may positively affect psychosocial status. For example, even mild improvements in physical fitness have been found to be effective in reducing depression and subsequent mortality 6 in cardiac rehabilitation. 7,8 In addition, secondary prevention programs targeting reductions in body mass index (BMI) have also been shown to be effective in reducing depression, improving social functioning and improving emotional functioning. 9, 10Depression Depression remains as one of the most significant psychosocial risk factors in secondary prevention and cardiac rehabilitation. Depression is implicated in both the onset of CHD as well as the prognosis in rehabilitation.11 Although estimates vary, depression confers a relative risk of onset of CHD in the range of 1.5-2.0 in initially healthy individuals.11 Among those diagnosed with CHD, rates of clinically significant depression has been identified in 15-20% of heart failure patients. 12,13 Depression is also clinically significant for its role in cardiac rehabilitation. Cardiac patients diagnosed with depression demonstrate poorer adherence to cardiac rehabilitation regimen, and increased odds of non-completion.14, 15 It is worth noting that although there is not strong research evidence, preliminary indications are that the somatic symptoms of depression such as fatigue, sleep disturbance and appetite disturbance have a greater effect on compliance and completion 15 as well as subsequent cardiac events. 16Lifestyle and behavioral factors play a major part in the development of coronary heart disease (CHD). Rehabilitation and secondary prevention of CHD mus...

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Effectiveness of nonpharmacological secondary prevention of coronary heart disease

Cited by 54 publications

References 59 publications

Exercise training programs in Dutch cardiac rehabilitation centres

Exercise training programs in Dutch cardiac rehabilitation centres

Joga i rehabilitacja kardiologiczna (Yoga-CaRe) u osób po przebyciu ostrego epizodu wieńcowego

Importance of psychosocial status in secondary prevention and rehabilitation of coronary artery disease

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