Exercise-Based Cardiac Rehabilitation and Improvements in Cardiorespiratory Fitness: Implications Regarding Patient Benefit

Franklin, Barry A.; Lavie, Carl J.; Squires, Ray W.; Milani, Richard V.

doi:10.1016/j.mayocp.2013.03.009

Cited by 97 publications

(61 citation statements)

References 40 publications

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“…We searched for publications on longevity and professional or elite athletes (with no restriction on the starting date and up to March 31, 2014). Results: Ten studies, including data from a total of 42,807 athletes (707 T here is strong epidemiological evidence that regular physical activity (eg, brisk walking and jogging) has great potential in the management and rehabilitation of various diseases 1,2 and is associated with lower risk of all-cause mortality, cardiovascular disease (CVD), hypertension, stroke, metabolic syndrome, type 2 diabetes, breast and colon cancer, depression, and falling. 3,4 However, whether the repeated exposure to the highest exercise levels, such as those required in professional sports participation, affects human longevity and disease risk remains an open question.…”

Section: Q16mentioning

confidence: 99%

Elite Athletes Live Longer Than the General Population: A Meta-Analysis

Garatachea

Santos‐Lozano

Sanchís-Gomar

et al. 2014

Mayo Clinic Proceedings

135

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Section: Q16mentioning

confidence: 99%

Elite Athletes Live Longer Than the General Population: A Meta-Analysis

Garatachea

Santos‐Lozano

Sanchís-Gomar

et al. 2014

Mayo Clinic Proceedings

135

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“…(36,74,75,(77)(78)(79)(80)(81)(82)(83)(84)(85)(86) Weight loss has been associated with marked improvements in arterial pressure and LV geometry, potentially improving HTN. (86) Additionally, exercise, a potential tool for weight loss, has been associated with increases in cardioprotective HDL-C, increased insulin sensitivity, and a decrease in the prevalence of MetS and DM.…”

Section: Weight Loss and Cadmentioning

confidence: 99%

“…(1,(88)(89)(90) What is certain is that fitness is important to improve prognosis among CAD patients (81)(82)(83) and, therefore, physical activity, exercise training and fitness improvements, with potentially accompanying purposeful weight loss, should be incorporated into treatment plans of overweight or obese patients with CAD. (84,85) …”

Section: Accepted Manuscriptmentioning

confidence: 99%

The relationship between obesity and coronary artery disease

Jahangir¹,

Schutter²,

Lavie³

2014

Translational Research

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Obesity continues to be a growing issue in the United States with an estimated prevalence of 72 million people. There are major health implications associated with obesity including its relationship with hypertension, diabetes mellitus type 2, the metabolic syndrome, and dyslipidemia, all independent risk factors for CAD. Despite the increased risk of developing CAD, in recent years an "obesity paradox" has been described in which moderately obese individuals with established cardiovascular disease, including CAD, appear to have mortality similar to their normal weight counterparts. This review discusses the relationship between obesity and CAD, including the increased risk of hypertension, diabetes mellitus, the metabolic syndrome, and dyslipidemia along with a discussion of the obesity paradox and the benefits of weight reduction.

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“…The variability is postulated to be based on reimbursement policies. Clearly, evidence is needed to demarcate minimum dose of CR needed to significantly improve patient quality and quantity of life, with consideration of case-mix 95 , so quality of care in countries/regions not meeting this minimum can be improved.With regard to core components delivered, exercise training was the most consistently offered one overall, but also in the regions of Europe and Latin America; this is laudable given that the greatest improvements in prognosis are explained by improvements in cardiorespiratory fitness achieved through physical activity [96][97][98][99] . Clearly great efforts are needed to increase CR penetration in healthcare systems across the globe, given these are highly cost-effective strategies [100][101][102][103] .…”

mentioning

confidence: 99%

A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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Herein, 28 publications describing cardiac rehabilitation (CR) delivery in 50 of the 113 countries globally suspected to deliver it are reviewed, to characterize the nature of services. Government funding was the main source of CR reimbursement in most countries (73%), with private and patient funding in about ¼ of cases.Myocardial infarction patients and those having revascularization were commonly served. The main professions delivering CR were physicians, nurses, and physiotherapists. Programs offered a median of 20 sessions, although this varied. Most programs offered the core components of exercise training, patient education and nutrition counselling. Alternative models were not commonly offered. Lack of human and/or financial resources as well as space constraints were reported as the major barriers to delivery. Overall, CR delivery has been characterized in less than half of the countries where it is offered. The nature of services delivered is fairly consistent with major CR guidelines and statements.Keywords: cardiac rehabilitation, global health, secondary prevention Alphabetical List of Abbreviations: AS= administrative support CABG = coronary artery bypass graft CB = community-based A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT2 CR = cardiac rehabilitation CPR= cardiopulmonary resuscitation CVD = cardiovascular disease ECG = electrocardiogram EQ= equipment ET = exercise training FR= financial resources HB = home-based HF = heart failure HR= human resources IA = initial assessment IB = internet-based IHD = ischemic heart disease LMIC = low-and middle-income country MI = myocardial infarction NC = nutrition counseling NZ = New Zealand PAW= patient awareness PCI = percutaneous coronary intervention PE = patient education PR= patient referral RF = risk factor management SC = smoking cessation SM = stress management and/or psychosocial support/counselling TI = transportation issues UAE = United Arab Emirates VAD = ventricular assist device A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 By 2030, it is expected 84 million individuals will be diagnosed with cardiovascular disease (CVD) 1 .Moreover, it is among the leading causes of disability around the world, and contributes to 10% of disabilityadjusted life years lost world-wide 2 . With improved survival (in high-income countries 3 ), clearly there is a great need for secondary prevention, such as is offered in cardiac rehabilitation (CR) programs.Many meta-analyses demonstrate that participation in CR is associated with improved quality of life, as well as decreased morbidity and mortality [4][5][6][7] . CR is also cost-effective 8 . Accordingly, it is a class 1 level A recommendation in clinical practice guidelines for CVD patients 9,10 . 19 , have established guidelines to ensure consistent provision and quality of CR delivery in order to achieve the greatest population health benefits. They all outline the nature of patients indicated for services, and make recommendations regarding the composition of a multi-disciplinary...

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Exercise-Based Cardiac Rehabilitation and Improvements in Cardiorespiratory Fitness: Implications Regarding Patient Benefit

Cited by 97 publications

References 40 publications

Elite Athletes Live Longer Than the General Population: A Meta-Analysis

Elite Athletes Live Longer Than the General Population: A Meta-Analysis

The relationship between obesity and coronary artery disease

A Review of Cardiac Rehabilitation Delivery Around the World

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