Changing clinical profile of patients entering cardiac rehabilitation/secondary prevention programs: 1996 to 2006

Abstract

Purpose: Cardiac rehabilitation (CR)/secondary prevention programming is dependent on clinical attributes of participants. We examined recent changes in the profile of individuals who are entering CR.

Methods: We analyzed data for all patients entering our phase II CR program from 1996 to 2006. Patients were classified into 5 groups on the basis of recruitment period: period 1 (1996-1998) (n = 604), period 2 (1999-2000) (n = 571), period 3 (2001-2002) (n = 588), period 4 (2003-2004) (n = 519), and period 5 (2005-2006) (n = 532).

Results: From period 1 to period 5, age increased from 60.6 to 63.4 years, and the proportion of patients 75 years or older increased by 59%. The proportion of women, initially 25%, did not change. Weight increased from 84.7 to 88.5 kg, whereas the proportion of patients with obesity, diabetes, and hypertension increased by 35%, 52%, and 48%, respectively. However, the proportion of patients with elevated blood pressure level did not change significantly. Peak relative aerobic capacity decreased by 10%. Total cholesterol, triglycerides, and low-density lipoprotein cholesterol decreased by 20%, 35%, and 27%, respectively, whereas high-density lipoprotein cholesterol increased by 12%. Use of all evidence-based cardiovascular drugs increased significantly, particularly statins (from 25% to 77%).

Conclusions: CR participants are now older, more frequently present with features of the metabolic syndrome, and are relatively less fit. However, a 3-fold increase in statin use over 10 years has contributed to a marked improvement of lipid parameters.