Navigation Links
Heart Patients More Likely to Adopt Healthy Habits in 3-Year Program Led by Cardiac Rehabilitation Experts, Mayo Clinic Research Shows
Date:6/4/2008

ROCHESTER, Minn., June 4 /PRNewswire-USNewswire/ -- People recovering from acute heart problems such as heart attack and heart surgery are more likely to develop habits to control heart attack risk factors when they meet regularly with cardiac "disease managers," according to researchers at Mayo Clinic in Rochester. These managers are nonphysician cardiac rehabilitation specialists who lead long-term follow-up programs that last three years. With these risk factors under control, heart patients are likely to live longer and have fewer heart problems, the Mayo researchers conclude.

The Mayo Clinic researchers studied the effects of a long-term cardiac disease manager model on 503 patients involved in cardiac rehabilitation. Their findings appear in The Journal of Cardiopulmonary Rehabilitation and Prevention, (http://www.jcrjournal.com/pt/re/jcardiorehab/abstract.01273116-200805000-0 0004.htm;jsessionid=LF6LdjP3QQ81SY2PjTbLQ9Tn1rGbBr5yszv1vyq6chS8wfhl1pgy!63 4347399!181195628!8091!-1). The disease manager's role was to monitor the patient's status, and to coach the patients in adopting heart attack prevention behaviors. At each meeting, the following factors were assessed and management strategies were discussed: blood lipid levels, blood pressure and body weight, tobacco use, cardiac medication compliance, exercise regimen and physical activity, nutrition and cardiopulmonary symptoms. After initial rehabilitation training about risk factor management, each patient met with a trained disease manager every three to six months for three years.

Their report demonstrates:

-- It is feasible to provide long-term disease management to heart patients in an outpatient setting. Mayo's model calls for trained cardiac rehabilitation specialists to function as disease managers who maintain a relationship with the patients and meet face-to-face every three to six months. This follows an initial intensive training period about lifestyle changes and medications. In contrast, aftercare programs often are only a few months long and lack coordination and direct involvement of health care providers who are specifically trained in cardiac rehabilitation, or who rigorously review clinical and lifestyle data.

-- The approach offers clear clinical benefits. At three years, the participants attained and maintained most of the behaviors for preventing subsequent heart attacks. These behaviors are known as secondary heart-attack prevention measures. They include exercising regularly and taking specific heart-protecting medications. Most lowered their cholesterol levels and blood pressure to within recommended levels. Of the 503 participants, compliance with aspirin usage was 91 percent; statin usage, 91 percent; beta-blocker usage, 78 percent; and angiotensin-converting enzyme inhibitor usage, 76 percent.

-- Patients in the disease manager model of care versus traditional care had a lower death rate. While larger studies will need to validate this finding, over the three years of the study, 29 participants died, (25 men and four women), an annual death rate of 1.9 percent. This compares to the Centers for Disease Control and Prevention's expected annual death rate of 1.6 percent for Americans of comparable ages in the general population without heart problems. By comparison, the annual death rate over three years for an additional group of 102 patients who were enrolled in cardiac rehabilitation but who did not receive long-term disease management, was 6.5 percent.

-- Being overweight remains a prevalent and persistent risk factor for heart attack. As measured by body mass index, being overweight was the one heart disease risk factor that did not respond well to this disease manager approach. Other studies also have shown body weight to be the most change-resistant variable in efforts to promote heart health.

Significance of the Mayo Research

The findings are important because heart disease is the number one cause of death and disability in the U.S. - and though many people survive due to advances in medical care, many patients and physicians don't realize the importance of cardiac rehabilitation in extending survival benefits. Mayo researchers developed the disease manager model of cardiac rehabilitation to extend the lifesaving benefits modern medicine offers, and spare patients the trauma and the expense of repeat surgeries and hospitalizations, says lead researcher Ray Squires, Ph.D.

"Earlier studies indicate that under traditional approaches, most patients don't comply with treatment recommendations, including taking medications and modifying their lifestyle. We need to change that," Dr. Squires says. For example, he says that during 2004 in Minnesota, 38 percent of coronary heart disease patients received optimal care for controlling heart attack prevention. The goals of heart attack prevention for patients with coronary heart disease in the Minnesota survey included:

-- Achieving a low-density lipoprotein (LDL) cholesterol of less than 100 milligrams per deciliter

-- Lowering blood pressure to less than 140 systolic and 90 diastolic

-- Taking a daily aspirin to help prevent blood clots

-- Quitting smoking

"This suggests the remaining 62 percent of Minnesota coronary heart disease patients in 2004 remained at higher risk of further heart problems," Dr. Squires says. "Our feeling is that medical science can offer more people better methods for living a heart-healthy - and longer - life. We designed our cardiac rehabilitation program to do that. Using the disease manager model, we have demonstrated that three years of intervention in routine clinical practice was generally effective in achieving secondary prevention goals."

Mayo's Leadership Role

Mayo Clinic is a leader nationally in emphasizing the savings in lives and costs that cardiac rehabilitation offers heart patients. "Many studies demonstrate that cardiac rehabilitation is extremely beneficial to patients, and the data also show that cardiac rehab is vastly underutilized," says Randal Thomas, M.D., director of the Cardiovascular Health Clinic at Mayo Clinic.

To improve the referral of patients to cardiac rehabilitation programs and to stimulate high-quality care in cardiac rehabilitation centers, Dr. Thomas recently helped draft new national performance measures. Adding a disease manager into this approach extends the benefits of cardiac rehabilitation, in his view. "The kind of cardiac rehabilitation program we'd like to see serves not only as a coach for the patient, but also as a key communicator in patient care, and a coordinator with other health care providers. When all those roles are filled, it's likely that patients get the follow-up care they need," Dr. Thomas says.

About the Study

Mayo's study is based on a review of the clinical progress made by 503 heart patients at Mayo treated under a long-term management model led by cardiac rehabilitation experts. Patients entered the rehabilitation program in 1999 and 2000. Of the patients, 54 percent were 65 years or older. All had suffered some form of acute cardiac event, such as a heart attack, or had undergone heart surgery.

Collaboration and Support

Other members of the research team are Aura Montero-Gomez, M.D., and Thomas Allison, Ph.D. Their work was supported by the Mayo Foundation for Medical Education and Research.

To obtain the latest news releases from Mayo Clinic, go to http://www.mayoclinic.org/news. MayoClinic.com (http://www.mayoclinic.com) is available as a resource for your health stories.


'/>"/>
SOURCE Mayo Clinic Public Affairs
Copyright©2008 PR Newswire.
All rights reserved

Related medicine technology :

1. Many Heart Attack Patients Dont Get Best Emergency Treatment
2. The Heart, Diabetes, And Weight Loss Centers of New York Introduce the New Science of Metabolic Diagnosis and Weight Management
3. American Heart Association Comment Saving Lives in Type 2 Diabetics: Could It Be as Easy as Lowering Blood Pressure?
4. Terumo Heart to Announce Results of European Clinical Trial of DuraHeart(TM) LVAS at European Association of Cardiothoracic Surgeons Meeting in September
5. WorldHeart Announces Further Milestone in Miniaturized Assist Pump Development
6. CellCyte Genetics Corp. Enters Collaborative Research Agreement With Cleveland Clinic Foundation to Qualify Stem Cell Delivery in Damaged Heart Tissue
7. Its Only Heartburn...or is it? Chronic Heartburn a Risk Factor for Precursor to Esophageal Cancer
8. Cleveland Clinic Study Shows the Diabetes Drug Pioglitazone Reduces Risk of Death, Heart Attack and Stroke, but Increases Risk of Heart Failure
9. Hypertension: Journal of the American Heart Association Rapid Access Reports: Hispanics Hypertension Better Controlled With Equal Access to Care
10. Terumo Heart Reports Summary of DuraHeart(TM) LVAS Clinical Trial Results
11. ECLIPSE Data on Effects of Otsukas Investigational Novel Treatment, Tolvaptan, on Advanced Heart Failure Patients Hemodynamics and Urine Output Featured in Heart Failure Society of Americas Late Breaking Trials
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/11/2016)... NEW YORK , Feb. 11, 2016 /PRNewswire/ ... a foot-focused suite of products designed to support ... ExoSOLS™, are custom orthotic insoles that combine years ... 1,000 partners in the podiatric field with cutting ... align, and propel . It is supported by ...
(Date:2/10/2016)... DUBLIN , February 11, 2016 /PRNewswire/ ... the addition of the "Molecular Diagnostics ... --> http://www.researchandmarkets.com/research/rp4pg8/molecular ) has announced ... Reports Bundle" report to their offering. ... http://www.researchandmarkets.com/research/rp4pg8/molecular ) has announced the addition of ...
(Date:2/10/2016)... och PITTSBURGH , ... lämnas inte, och detta pressmeddelande får inte ... eller till, och inga anmälningssedlar kommer att ... i, något land där Erbjudandet, distribution av ... Erbjudandet skulle strida mot tillämpliga lagar eller ...
Breaking Medicine Technology:
(Date:2/11/2016)... Colorado (PRWEB) , ... February 11, 2016 , ... Colorado ... Review as one of 334 spine surgeons to know in 2016 . The ... in the field of spine surgery. , Dr. Corenman understands the importance of ...
(Date:2/11/2016)... ... February 11, 2016 , ... The annual list showcases the 20 Most Promising ... team dedication and commitment to the SharePoint ecosystem. A panel of experts and ... goal is to recognize and promote technology entrepreneurship. , The survey was made ...
(Date:2/11/2016)... ... February 11, 2016 , ... Husted Kicking ... San Diego, CA, on February 6th & 7th, 2016 according to kicking coach Michael ... were not invited to the NFL’s combine in Indianapolis,” says Husted. “The NFL uses ...
(Date:2/10/2016)... ... , ... President Obama’s budget proposal yesterday enables the HHS ... via telehealth, estimated to generate more than $160 million in savings over 10 ... Although there is more to be done, this represents an important victory ...
(Date:2/10/2016)... ... February 10, 2016 , ... ... , a full-service health care communications company offering education, research and medical ... for practitioners and specialists working in infectious diseases. , As the all-inclusive ...
Breaking Medicine News(10 mins):