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Cardiac rehabilitation saves lives

February 25, 2009 Toronto

People who participate in cardiac rehabilitation after experiencing a major heart event cut the risk of dying from a subsequent heart event in half, according to a new study published in the February issue of the European Journal of Cardiovascular Prevention and Rehabilitation.

The study, conducted by Dr. David Alter, Institute for Clinical Evaluative Studies (ICES), and Dr. Paul Oh, Toronto Rehabilitation Institute (Toronto Rehab), compared the long-term survival rate of more than 4,000 people who had been hospitalized due to a heart event, such as a heart attack. Half of the study cohort completed a one-year cardiac rehabilitation program while the other half did not. The participants who got cardiac rehabilitation received information and coaching about the changes they needed to make to live heart-healthier lifestyles. Consequently, they experienced a decreased mortality rate.

"The study highlights the importance of behaviour patterns in the population,” says Dr. Alter, senior scientist, ICES, and adjunct scientist, Toronto Rehab. “The survival benefits predominantly applied to those individuals who both participated in and complied with the cardiac rehabilitation program. In contrast, those who did not attend cardiac rehabilitation classes did not experience significant survival improvements. This demonstrates the significance of cardiac rehabilitation following a heart event."

According to the Heart and Stroke Foundation, 73 per cent of the 70,000 Canadians who have heart attacks annually survive the event. Close to half of these people continue to experience heart-related problems, including chest pain, a restricted lifestyle and a high risk of having an additional heart attack. More than 2 million other Canadians are living with cardiovascular diseases.

Despite the proven benefits of cardiac rehabilitation, studies show that only 30 per cent of people who would benefit from taking part in a cardiac rehabilitation program actually enroll in one. Dr. Oh, medical director of Toronto Rehab’s Cardiac Rehabilitation and Secondary Prevention program, hopes this new study will underscore the importance of rehabilitation after a serious heart event.

“We know that cardiac rehabilitation saves lives,” says Dr. Oh. “Our program teaches people the importance of eating a proper diet, exercising regularly, getting enough sleep and having healthy relationships. If you, or someone you know, has experienced a heart event or has multiple risk factors, such as diabetes, high blood pressure or high cholesterol, speak to your doctor about a referral to a cardiac rehabilitation program.”

Michael Irving, 59, knows first-hand the benefits of completing a cardiac rehabilitation program. According to Irving, “Toronto Rehab’s cardiac rehab program saved my life and improved the quality of life for those around me.”

Irving experienced a major heart attack in summer 2007. He survived, however, the overweight and overstressed sculptor and psychotherapist knew he was destined to continue experiencing heart problems if he didn’t make major lifestyle changes. Therefore, he asked his physician to refer him to the Cardiac Rehabilitation and Secondary Prevention program at Toronto Rehab – the largest and longest-running cardiac rehabilitation outpatient program in North America.

Two years later, Irving has lost more than 80 lbs and is continuing to practice the heart-healthy lifestyle changes he learned in the program.

“If my heart attack had occurred 30 years ago, I would have been told to go home, get my affairs in order and expect not to see the end of the year,” says Irving. “Cardiac rehabilitation practices have effectively turned these notions around 180-degrees by identifying lifestyle approaches that lead to a productive and vibrant heart-healthy life.”

About the study
The study “Relationship between cardiac rehabilitation and survival after acute cardiac hospitalization within a universal health care system” followed 4,084 people who had been hospitalized between 1999 and 2003 from cardiac events. Each patient survived at least one year without recurrent admissions after discharge from the original admission, and was followed for a mean of 5.25 years. Cardiac rehabilitation participants experience a 50 per cent lower mortality rate compared with the population-matched participants who did not undergo a rehabilitation program (2.6 vs. 5.1 per cent respectively, P<0.001).

About cardiac rehabilitation
Toronto Rehab’s Cardiac Rehabilitation and Secondary Prevention program is based on a scientifically-proven and medically-supervised course of exercise, education and lifestyle modification aimed at providing patients with the information, motivation and support they need to adopt and maintain heart-healthy habits. The ultimate goals of the program are to limit the physiological effects of cardiac illness and to improve overall cardiovascular fitness and health.

About ICES
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

About Toronto Rehab
Toronto Rehab is at the forefront of one of the most important and emerging frontiers in health care today - rehabilitation science. As a fully affiliated teaching and research hospital of the University of Toronto, Toronto Rehab is Canada's largest academic provider of adult rehabilitation services, complex continuing care and long-term care. Toronto Rehab is advancing rehabilitation knowledge and practice through research and education.

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