Summaries for Patients |

The Effectiveness of Cardiac Rehabilitation Programs with and without Exercise Components FREE

[+] Article, Author, and Disclosure Information

The summary below is from the full report titled “Meta-Analysis: Secondary Prevention Programs for Patients with Coronary Artery Disease.” It is in the 1 November 2005 issue of Annals of Internal Medicine (volume 143, pages 659-672). The authors are A.M. Clark, L. Hartling, B. Vandermeer, and F.A. McAlister.

Ann Intern Med. 2005;143(9):I-87. doi:10.7326/0003-4819-143-9-200511010-00004
Text Size: A A A

What is the problem and what is known about it so far?

Coronary artery disease (CAD) is the result of blockages in the heart's blood vessels. Low blood flow to the heart due to blocked vessels causes chest pain or “angina.” If angina lasts long enough, a section of heart muscle dies, a condition called myocardial infarction (or “heart attack”). Risk factors for CAD include older age, male sex, high blood pressure, diabetes, smoking, high levels of total or low-density lipoprotein (“bad”) cholesterol and low levels of high-density lipoprotein (“good”) cholesterol, and family history of CAD. Modifying these risk factors after a heart attack can reduce a person's chance of having another heart attack. Doctors advise patients who have had a heart attack to participate in organized programs, called cardiac rehabilitation programs or secondary cardiac prevention programs, to reduce cardiac risk. The programs provide education and counseling to help patients improve or eliminate factors that are associated with CAD (unfavorable cholesterol levels, high blood pressure, smoking, and physical inactivity). They also often, but not always, include supervised exercise. Previous studies have established that cardiac rehabilitation programs that include supervised exercise improve survival after heart attack. However, the effectiveness of cardiac rehabilitation programs that do not include supervised exercise is less clear.

Why did the researchers do this particular study?

To see whether cardiac rehabilitation programs improve outcomes for people after heart attack regardless of whether they include supervised exercise.

Who was studied?

21,295 patients with CAD who were included in 63 randomized trials.

How was the study done?

The researchers searched computer databases of published studies from 1966 to 2004 to identify studies that randomly assigned patients to different types of cardiac rehabilitation programs to study whether the patients who participated in the programs had better survival, quality of life, and ability to carry out daily activities than patients who did not participate in the programs. They used a statistical technique called meta-analysis to combine the results of the various studies.

What did the researchers find?

Sixty-three studies of cardiac rehabilitation programs met their criteria. Overall, patients who participated in cardiac rehabilitation programs had better survival after heart attack than patients who did not participate in a program. Improvements in quality of life and ability to carry out daily activities were also better in patients who participated in cardiac rehabilitation programs. The programs seemed to be beneficial regardless of whether they included supervised exercise. However, the results suggest that the programs with supervised exercise might have a larger benefit than those that did not include exercise.

What were the limitations of the study?

Many included studies were of poor quality. No large, high-quality studies directly compared programs with exercise and those without exercise.

What are the implications of the study?

Cardiac rehabilitation programs seem to improve outcomes for patients after heart attack regardless of whether the programs include supervised exercise.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Association Between Phase 3 Cardiac Rehabilitation and Clinical Events. J Cardiopulm Rehabil Prev Published online Sep 26, 2016;
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.