Philip A Ades1, Patrick D Savage. 1. Division of Cardiology, Department of Medicine, The University of Vermont, Larner College of Medicine, Burlington.
Abstract
BACKGROUND: Cardiac rehabilitation (CR) programs have evolved from exercise-only programs designed to improve cardiorespiratory fitness to secondary prevention programs with a broader mandate to alter lifestyle-related behaviors that control cardiac risk factors and, thereby, reduce overall cardiovascular risk. As the obesity epidemic has evolved in the late 20th and early 21st centuries, the prevalence of type 2 diabetes mellitus and the metabolic syndrome have soared and blunted the otherwise expected downturn in deaths from coronary heart disease related to better control of risk factors. In that the causes of obesity are behavioral in origin, the most effective treatment strategy requires a comprehensive, behavioral-based approach. PURPOSE: In this review, we outline optimal lifestyle approaches that can be delivered in the CR setting to assist cardiac patients with their long-term goals of reducing weight and improving cardiac risk factors while concurrently improving cardiorespiratory fitness. We also performed a survey of CR program throughout the United States and found that only 8% currently deliver a behavioral weight programs. CONCLUSIONS: Cardiac rehabilitation programs need to take on an important challenge of secondary prevention, which is to develop behavioral weight loss programs to assist cardiac patients to lose weight and, thereby, improve multiple risk factors and long-term prognosis.
BACKGROUND: Cardiac rehabilitation (CR) programs have evolved from exercise-only programs designed to improve cardiorespiratory fitness to secondary prevention programs with a broader mandate to alter lifestyle-related behaviors that control cardiac risk factors and, thereby, reduce overall cardiovascular risk. As the obesity epidemic has evolved in the late 20th and early 21st centuries, the prevalence of type 2 diabetes mellitus and the metabolic syndrome have soared and blunted the otherwise expected downturn in deaths from coronary heart disease related to better control of risk factors. In that the causes of obesity are behavioral in origin, the most effective treatment strategy requires a comprehensive, behavioral-based approach. PURPOSE: In this review, we outline optimal lifestyle approaches that can be delivered in the CR setting to assist cardiac patients with their long-term goals of reducing weight and improving cardiac risk factors while concurrently improving cardiorespiratory fitness. We also performed a survey of CR program throughout the United States and found that only 8% currently deliver a behavioral weight programs. CONCLUSIONS: Cardiac rehabilitation programs need to take on an important challenge of secondary prevention, which is to develop behavioral weight loss programs to assist cardiac patients to lose weight and, thereby, improve multiple risk factors and long-term prognosis.
Authors: Scott M Grundy; James I Cleeman; Stephen R Daniels; Karen A Donato; Robert H Eckel; Barry A Franklin; David J Gordon; Ronald M Krauss; Peter J Savage; Sidney C Smith; John A Spertus Journal: Crit Pathw Cardiol Date: 2005-12
Authors: William C Knowler; Elizabeth Barrett-Connor; Sarah E Fowler; Richard F Hamman; John M Lachin; Elizabeth A Walker; David M Nathan Journal: N Engl J Med Date: 2002-02-07 Impact factor: 91.245
Authors: Diann E Gaalema; Patrick D Savage; Kevin Leadholm; Jason Rengo; Shelly Naud; Jeffrey S Priest; Philip A Ades Journal: J Cardiopulm Rehabil Prev Date: 2019-07 Impact factor: 2.081
Authors: J R Schairer; T Kostelnik; S M Proffitt; K I Faitel; S Windeler; L B Rickman; C A Brawner; S J Keteyian Journal: J Cardiopulm Rehabil Date: 1998 Jul-Aug Impact factor: 2.081
Authors: Justo Sierra-Johnson; Abel Romero-Corral; Virend K Somers; Francisco Lopez-Jimenez; Randal J Thomas; Ray W Squires; Thomas G Allison Journal: Eur J Cardiovasc Prev Rehabil Date: 2008-06
Authors: Joseph E Donnelly; Steven N Blair; John M Jakicic; Melinda M Manore; Janet W Rankin; Bryan K Smith Journal: Med Sci Sports Exerc Date: 2009-02 Impact factor: 5.411
Authors: K G M M Alberti; Robert H Eckel; Scott M Grundy; Paul Z Zimmet; James I Cleeman; Karen A Donato; Jean-Charles Fruchart; W Philip T James; Catherine M Loria; Sidney C Smith Journal: Circulation Date: 2009-10-05 Impact factor: 29.690
Authors: John P H Wilding; Rachel L Batterham; Salvatore Calanna; Melanie Davies; Luc F Van Gaal; Ildiko Lingvay; Barbara M McGowan; Julio Rosenstock; Marie T D Tran; Thomas A Wadden; Sean Wharton; Koutaro Yokote; Niels Zeuthen; Robert F Kushner Journal: N Engl J Med Date: 2021-02-10 Impact factor: 91.245
Authors: Caitlan A Tighe; Daniel J Buysse; Debra K Weiner; Gregory P Beehler; Daniel E Forman Journal: J Cardiopulm Rehabil Prev Date: 2022-05-02 Impact factor: 3.646
Authors: Brittany E Smith; James E Peterman; Matthew P Harber; Mary T Imboden; Bradley S Fleenor; Leonard A Kaminsky; Mitchell H Whaley Journal: Diabetes Metab Syndr Obes Date: 2022-05-20 Impact factor: 3.249