Tag Archives: cardiac rehabilitation

The main objective of cardiovascular prevention and rehabilitation in clinical practice is to reduce the risk of future vascular events, to improve quality of life and increase life expectancy. Cardiac rehabilitation (CR) is recommended by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR).1 This second edition of the Standards and Core Components (SCC) for Cardiovascular Disease Prevention and Rehabilitation from the BACPR, define CR through seven standards and seven core components for assuring a quality service of care using a multi-disciplinary biological and psychosocial approach.2 However, the implementatio

Background Statins are first choice for treatment of dyslipidaemia in both secondary and primary cardiovascular disease prevention. For every 1.0 mmol/L reduction in low-density lipoprotein cholesterol (LDL‑C), the risk of coronary heart disease (CHD) mortality decreases by 19% and overall mortality decreases by 12%.1 Despite statin treatment, a substantial number of cardiovascular events still occur, and one reason may be persistent lipid abnormalities including total cholesterol and LDL-C not at target, or low levels of high-density lipoprotein cholesterol (HDL-C) or elevated triglycerides. Results from the DYSlipidaemia International Stu

The programme is implemented according to national evidence-based guidelines and local policies. The programme integrates primary and secondary prevention in one programme and recruits all those who will benefit the most, i.e. patients with vascular disease, those at high risk of developing disease, and the close family members of the above, and takes into account the groups in which the prevalence of cardiovascular disease and risk factors is the highest. The programme is family centred and so recruits the spouse and/or others close to the patient in order to maximise the potential for adoption of positive healthy behaviours. Wherever possib

MyAction Westminster: background In response to the Department of Health (DoH) policy document Putting Prevention First,1 NHS Westminster launched its Health Checks programme in primary care in 2009. The MyAction Westminster programme was concomitantly commissioned by NHS Westminster so that those individuals identified to be at high cardiovascular disease (CVD) risk through the Health Checks could access, with their families, an effective vascular prevention programme that would help them achieve measurably healthier lives. Imperial College Healthcare NHS Trust were successful in becoming the providers of the programme with an annual budget

Background Cardiovascular disease (CVD) is the single most common cause of death in Ireland, with diseases of the circulatory system accounting for 33.5% of deaths.1 While there has been a significant decline in death rates over the last 30 years, CVD mortality rates in Ireland remain high in comparison with European averages.2 There is compelling evidence that managing risk factors through lifestyle intervention and cardioprotective drug management can reduce cardiovascular morbidity and mortality by up to 90%.3 In Ireland, high-risk approaches to prevention have traditionally targeted those with established heart disease, yet there are many

Introduction Exercise is well recognised as a tool for assessment, prevention and management of cardiovascular disease.1 Cardiac patients are encouraged to attend cardiac rehabilitation programmes including elements of supervised exercise. Such programmes can reduce mortality and morbidity rates by up to 27%.2,3 Despite the benefits derived from participation in exercise-based cardiac rehabilitation, exercise itself may act as a trigger for myocardial ischaemia or cardiac arrest in patients with established coronary heart disease.4 During rehabilitation, cardiovascular event rates range from 12.3 to 37.4 per million patient hours of exercise.

NICE updates A new ‘Evidence Update’ has been produced by the National Institute for Health and Clinical Excellence (NICE), which summarises selected new evidence relevant to the NICE guideline on the management of chronic heart failure (CHF) in adults in primary and secondary care (clinical guideline 108).NICE says “Whilst Evidence Updates do not replace current accredited guidance, they do highlight new evidence that might generate a future changes in practice.”  It says it will welcome feedback from societies and individuals in developing this service. The update is available from www.evidence.nhs.uk/evidence-update-2. New guides

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Barbara Conway’s research explored the reasons why people from deprived socio-economic backgrounds access phase 3 cardiac rehabilitation services less than others. She calls these patients the ‘unheard’ in the health service. The study gathered interview data from 10 inhabitants of the five poorest electoral wards in Darlington, aiming to discover common beliefs about the health services which might cause the discrepancy. Some of the findings looked at inhibitors to cardiac rehabilitation with participants saying that they could not see the perceived benefit of cardiac rehabilitation in achieving lifestyle goals. Instead they focused on

Twenty-eight English Cardiac Networks were surveyed annually from 2007 to 2009 using an email questionnaire to the network coordinators. There was a 100% response rate with the majority showing agreed work plan progress. Only 50% have a lead cardiologist for each programme. Although networks are committed to National Audit of Cardiac Rehabilitation (NACR), data submission remains non-uniform across 61% of networks. National Service Framework (NSF) standards were achieved by 41% in 2007, 47% in 2008 and 50% in 2009. National Institute for Health and Clinical Excellence (NICE) post myocardial infarction (MI) guidelines including CR were met by