An Ounce of Prevention: How Cardiac Rehab Can Keep Your Heart Healthy
A cardiac emergency demands immediate medical action, but there are other steps you can take both before and after heart surgery to maintain and improve your heart health.
That’s why healthcare providers are offering medically supervised prehab and rehab cardiac programs for patients with heart disease.
“For patients to feel better, rehab is the key,” says Christie Glass, RN with Henry County Medical Center. “There is well-established data showing patients who participate in a structured rehab program following cardiac surgery, coronary intervention or a medically treated heart attack recover quicker—and often to a greater extent—than those who do not.”
Rehab for recovery
“Even after patients have been correctly and successfully treated for their illness with medication or a procedure, there is overall deconditioning of the entire body in response to illness,” says Glass. “Ideally, CV [cardiovascular] rehabilitation is the final step in the treatment process to restore patients to their original functional capacity.”
The diverse care team involved in cardiac rehab often comes as a surprise to patients. Cardiac nurses and other experts work together to provide rehab patients with exercise training, nutrition and stress management counseling, smoking cessation assistance, and education on medications and heart-healthy living. Most programs involve three hour-long sessions a week for about 12 weeks.
“The key to success is coming regularly and getting in the habit of living a heart-healthy lifestyle,” says Glass.
A typical rehab session might involve nutrition instruction or guidance in meditation or other stress management techniques, followed by stretching, aerobic exercise and a cooldown.
“We also make sure patients are managing their medications well and do a monthly review of their progress and goals,” Jessica Thompson, RN says.
In addition, patients always wear heart monitors while exercising so Registered Nurses (RNs) can ensure their safety. “Many patients worry about what sort of activity they can handle after a significant cardiac event,” says Amanda Flood, RN. “Adding activity while on a cardiac monitor allows them to do more, faster.”
Cardiac rehab health perks
Research from the University of Ottawa (Canada) Heart Institute shows that cardiac rehab reduces a patient’s risk of death from heart disease by 31 percent, and the risk of death from all causes by 27 percent.
Other health benefits include:
- Improved cholesterol, blood pressure, overall health and quality of life
- Increased ability to exercise and to cope with stress, anxiety and depression
- Increased likelihood of quitting smoking
- Reduced angina pain and heart disease progression
- Reduced need for cardiac medications
- Lower risk for further disability, emergency department visits and hospital readmission
Is cardiac rehab for you?
Both the American College of Cardiology and the American Heart Association give cardiac rehab a Class 1 recommendation (their strongest) for patients who have had a heart attack. Yet others can benefit from a cardiac rehab program as well, especially if one of these medical issues is involved:
- Coronary artery disease (CAD)
- Heart failure
- Heart procedure or surgery, including:
- Coronary artery bypass graft (CABG) surgery
- Percutaneous coronary intervention (PCI), including coronary angioplasty (balloon angioplasty) and stenting
- Valve replacement
- Pacemaker or implantable cardioverter defibrillator (ICD)
Keeping Your Bones Healthy and Strong
Bones are living tissue that are constantly being broken down and replaced. As we get older, the ability of bones to replenish themselves decreases and can result in weak bones that break easily. If the bones get weak and brittle enough it is called Osteoporosis.
Osteoporosis can affect men and women of all races and ages but white and Asian women that are past menopause are at the highest risk. Other things that increase the risk for weak bones include low levels of estrogen, thyroid problems, having stomach bypass surgery, use of certain medications such as steroids and medical problems such as kidney or liver disease as well as inflammatory bowel disease. Although it is not possible to change these risk factors, it is possible to change other potential causes of Osteoporosis. “A few simple life changes can help keep your bones strong and help prevent a broken hip, stooped posture and back pain that comes from collapsing of the bones in your spine” says Dr. Cutright.
Steps to Stronger Bones
Many factors that increase the risk of Osteoporosis can be prevented with lifestyle changes. For example:
- Decreasing or stopping use of tobacco products
- Consuming less than two alcoholic drinks per day
- Being active
- Getting enough Calcium and Vitamin D in your diet
- Maintaining an appropriate body weight – being too thin results in lower bone mass which = weaker bones. Too much weight increases the risk of arm and wrist fractures.
Good nutrition and exercise are very important to keeping your bones healthy.
Exercise will help your bones no matter how old you are when you start but will do the most good if done regularly and started when you are young. Strength training, weight-bearing and balance exercises are the best. Examples of weight bearing activities include walking, jogging, stair climbing, skipping rope and skiing. Yoga or tai chi are exercises that will help with balance that reduces the risk of falls that can cause broken bones.
Calcium and Vitamin D are very important to bone health. You need approximately 1200 mg of Calcium and 600 IU of vitamin D daily.
Foods high in calcium include:
- milk- especially soy and almond milk
- broccoli and Kale
- fortified oatmeal
- orange juice
Foods high in vitamin D include:
- Salmon, tuna, sardines, mackerel, shrimp
- egg yolk
- beef liver
- foods with added vitamin D include milk and some cereals.
Soy protein has also been shown to act similar to estrogen on bones and is therefore a helpful dietary product to improve bone health in women who have had a hysterectomy or have gone through menopause.
Screening for osteoporosis with a bone density test is recommended for all women by age 65 and men by age 70. But sooner testing is recommended if you have a family history of Osteoporosis or any of the risk factors listed above.
“Preventing broken bones is also about using common sense and avoiding risky situations” says Dr. Cutright. If you don’t have to be outside on a snowy or icy day – wait for more suitable conditions. Furthermore, he states “I have treated many broken bones that have resulted from people using a chair to stand on instead of getting a proper ladder”.
Roasted Asparagus, Beans and Greens Salad
This delicious entrée of asparagus, beans and greens salad is robust and doesn’t require meat to make it nutritious. Round out the meal with whole-grain bread and fresh sliced strawberries, plain or topped with a dollop of Greek yogurt.
1 pound asparagus, trimmed
4 cups mixed salad greens
1 (15-ounce) can cannellini beans, rinsed and drained
1/4 cup chopped scallions, tops only
2 tablespoons orange juice
1 tablespoon olive oil
1 tablespoon white wine vinegar
1 teaspoon Dijon-style mustard
1/4 teaspoon salt
1/4 teaspoon pepper
6 tablespoons shredded Parmesan cheese
Lightly spray a medium-size roasting pan with olive oil-flavored cooking spray. Arrange asparagus in pan. Spray again. Roast asparagus in preheated 400-degree oven for 20 minutes or until tender. Remove and cool to room temperature. Cut asparagus into bite-size pieces and place in large salad bowl. Add salad greens, beans and scallions. Toss gently.
Combine orange juice, oil, vinegar, mustard, salt and pepper in a cup. Stir well. Pour over salad. Sprinkle cheese over salad. Toss gently but well. Serve immediately.
Makes 4 (1-1/2-cup) servings.
Per serving: 180 calories / 6.5 grams total fat / 11 grams protein / 20 grams carbohydrates / 6 milligrams cholesterol / 450 milligrams sodium / 7 grams dietary fiber