Cardiac rehabilitation (CR) is defined by the World Health Organization (WHO) as "the sum of activity and interventions required to ensure the best possible physical, mental, and social conditions so that patients with chronic or post-acute cardiovascular disease may, by their own efforts, preserve or resume their proper place in society and lead an active life".[1] CR is a comprehensive model of care delivering established core components, including structured exercise, patient education, psychosocial counselling, risk factor reduction and behaviour modification, with a goal of optimizing patient's quality of life and reducing the risk of future heart problems.[2][3]
CR is delivered by a multi-disciplinary team, often headed by a physician such as a cardiologist.[4] Nurses support patients in reducing medical risk factors such as high blood pressure, high cholesterol and diabetes. Physiotherapists or other exercise professionals develop an individualized and structured exercise plan, including resistance training. A dietitian helps create a healthy eating plan. A social worker or psychologist may help patients to alleviate stress and address any identified psychological conditions; for tobacco users, they can offer counseling or recommend other proven treatments to support patients in their efforts to quit. Support for return-to-work can also be provided. CR programs are patient-centered.
Based on the benefits summarized below, CR programs are recommended by the American Heart Association / American College of Cardiology[5] and the European Society of Cardiology,[6] among other associations.[7][8] Patients typically enter CR in the weeks following an acute coronary event such as a myocardial infarction (heart attack), with a diagnosis of heart failure, or following percutaneous coronary intervention (such as coronary stent placement), coronary artery bypass surgery, a valve procedure, or insertion of a rhythm device (e.g., pacemaker, implantable cardioverter defibrillator).[9]
^WHO Expert Committee on Rehabilitation after Cardiovascular Diseases, with Special Emphasis on Developing Countries. Rehabilitation after cardiovascular diseases, with special emphsis on developing countries : report of a WHO expert committee. Geneva. ISBN 9241208317. OCLC 28401958.
^Cowie A, Buckley J, Doherty P, Furze G, Hayward J, Hinton S, et al. (April 2019). "Standards and core components for cardiovascular disease prevention and rehabilitation". Heart. 105 (7): 510–515. doi:10.1136/heartjnl-2018-314206. PMC 6580752. PMID 30700518.
^Grace SL, Turk-Adawi KI, Contractor A, Atrey A, Campbell N, Derman W, et al. (September 2016). "Cardiac rehabilitation delivery model for low-resource settings". Heart. 102 (18): 1449–1455. doi:10.1136/heartjnl-2015-309209. PMC 5013107. PMID 27181874.
^Supervia M, Turk-Adawi K, Lopez-Jimenez F, Pesah E, Ding R, Britto RR, et al. (August 2019). "Nature of Cardiac Rehabilitation Around the Globe". eClinicalMedicine. 13: 46–56. doi:10.1016/j.eclinm.2019.06.006. PMC 6733999. PMID 31517262.
^Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. (November 2011). "AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation". Circulation. 124 (22): 2458–2473. doi:10.1161/CIR.0b013e318235eb4d. PMID 22052934.
^Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. (August 2016). "2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)". European Heart Journal. 37 (29): 2315–2381. doi:10.1093/eurheartj/ehw106. PMC 4986030. PMID 27222591.
^Guha S, Sethi R, Ray S, Bahl VK, Shanmugasundaram S, Kerkar P, et al. (April 2017). "Cardiological Society of India: Position statement for the management of ST elevation myocardial infarction in India". Indian Heart Journal. 69 (Suppl 1): S63–S97. doi:10.1016/j.ihj.2017.03.006. PMC 5388060. PMID 28400042.
^"Quality statement 7 (developmental): Options for cardiac rehabilitation | Chronic heart failure in adults | Quality standards". www.nice.org.uk. Retrieved 2022-09-06.
^Grace SL, Turk-Adawi KI, Contractor A, Atrey A, Campbell NR, Derman W, et al. (2016-11-01). "Cardiac Rehabilitation Delivery Model for Low-Resource Settings: An International Council of Cardiovascular Prevention and Rehabilitation Consensus Statement" (PDF). Progress in Cardiovascular Diseases. Controversies in Hypertension. 59 (3): 303–322. doi:10.1016/j.pcad.2016.08.004. PMID 27542575.
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