Tag Archives: cardiovascular prevention and rehabilitation

Introduction It has been estimated that around one in four people who attend a cardiovascular prevention and rehabilitation programme (CPRP) have diabetes mellitus (DM) and many more are at risk of this condition.1 CPRPs provide an ideal opportunity to help support people with DM through optimisation of their medical therapies, diet and exercise. However, medications such as insulin and insulin secretagogues (sulfonylureas) increase the risk of hypoglycaemia during aerobic exercise.2,3 Repeated bouts of hypoglycaemia increase the risk of cardiovascular mortality,4,5 hypoglycaemia unawareness,6 disability,7 and reduce physical activity adheren

Introduction In 1988 the ISIS-2 (Second International Study of Infarct Survival) study brought about a sea change in the management of the patient suffering a myocardial infarction (MI) and, in particular, those who had ST-elevation (STEMI) changes on their electrocardiogram (ECG).1 Prior to that landmark trial, general practitioners (GPs) were much more involved in the care of patients suffering MIs. They had to decide with what urgency the patient had to be admitted, or even if they would be admitted at all, in the light of how little could be done for the patient in hospital. The care provided has improved since then to the point that the

Introduction In the UK, it is recommended that patients participating in the exercise component of a cardiovascular prevention and rehabilitation programme (CPRP) should undergo a baseline assessment of their cardiorespiratory fitness (CRF).1,2 The rationale behind this assessment is to measure programme outcomes, risk stratification and provide information for physical activity advice. In the UK, many CPRP use the Chester step test (CST), incremental shuttle walk test (ISWT), or the six-minute walk test (6MWT) to assess the changes in CRF following an exercise intervention.2 The choice of exercise test is usually dependent on the patient’s