Clinical and Demographic Trends in Cardiac Rehabilitation: 1996-2015
| Autor: | Patrick D. Savage, Jason L. Rengo, Kevin Leadholm, Diann E. Gaalema, Philip A. Ades, Jeff S. Priest, Shelly Naud |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Heart Diseases medicine.medical_treatment 030204 cardiovascular system & hematology Overweight Article Body Mass Index 03 medical and health sciences Coronary artery bypass surgery 0302 clinical medicine Sex Factors Risk Factors Diabetes mellitus Internal medicine Medicine Humans Obesity Demography Rehabilitation Cardiac Rehabilitation Exercise Tolerance business.industry Smoking Age Factors Type 2 Diabetes Mellitus Middle Aged medicine.disease United States 030228 respiratory system Diabetes Mellitus Type 2 Heart valve repair Hypertension Female medicine.symptom Cardiology and Cardiovascular Medicine business Body mass index |
| Zdroj: | J Cardiopulm Rehabil Prev |
| Popis: | Purpose Clinical interventions in programs such as cardiac rehabilitation (CR) are guided by clinical characteristics of participating patients. This study describes changes in CR participant characteristics over 20 yr. Methods To examine changes in patient characteristics over time, we analyzed data from 1996 to 2015 (n = 5396) garnered from a systematically and prospectively gathered database. Linear, logistic, multinomial logistic or negative binomial regression was used, as appropriate. Effects of sex and index diagnosis were considered both as interactions and as additive effects. Results Analyses revealed that mean age increased (from 60.7 to 64.2 yr), enrollment of women increased (from 26.8% to 29.6%), and index diagnosis has shifted; coronary artery bypass surgery decreased (from 37.2% to 21.6%), whereas heart valve repair/replacement increased (from 0% to 10.6%). Risk factors also shifted with increases in body mass index (28.7 vs 29.6 kg/m), obesity (from 33.2% to 39.6%), hypertension (from 51% to 62.5%), type 2 diabetes mellitus (from 17.3% to 21.7%), and those reporting current smoking (from 6.6% to 8.4%). Directly measured peak aerobic capacity remained relatively stable throughout. The proportion of patients on statin therapy increased from 63.6% to 98.9%, coinciding with significant improvements in lipid levels. Conclusions Compared with 1996, participants entering CR in 2015 were older, more overweight, and had a higher prevalence of coronary risk factors. Lipid values improved substantially concurrent with increased statin use. While the percentage of female participants increased, they continue to be underrepresented. Patients with heart valve repair/replacement now constitute 10.6% of the patients enrolled. Clinical programs need to recognize changing characteristics of attendees to best tailor interventions. |
| Databáze: | OpenAIRE |
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