Is the Clinical Delivery of Cardiac Rehabilitation in an Australian Setting Associated with Changes in Physical Capacity and Cardiovascular Risk and Are Any Changes Maintained for 12 Months?

Abstract

Long-term maintenance of changes in cardiovascular risk factors and physical capacity once patients leave the supervised program environment have not previously been reported. This study investigated the changes in physical capacity outcomes and cardiovascular risk factors in an Australian cardiac rehabilitation setting, and the maintenance of changes in these outcomes in the 12 months following cardiac rehabilitation attendance. Improvements in mean (95% CI) cardiorespiratory fitness (16.4% (13.2–19.6%), p < 0.001) and handgrip strength (8.0% (5.4–10.6%), p < 0.001) were observed over the course of the cardiac rehabilitation program, and these improvements were maintained in the 12 months following completion. Waist circumference (p = 0.003) and high-density lipoprotein cholesterol (p < 0.001) were the only traditional cardiovascular risk factors to improve during the cardiac rehabilitation program. Vigorous-intensity aerobic exercise was associated with significantly greater improvements in cardiorespiratory fitness, Framingham risk score, and waist circumference in comparison to moderate-intensity exercise. An increase in the intensity of the exercise prescribed during cardiac rehabilitation in Australia is recommended to induce larger improvements in physical capacity outcomes and cardiovascular risk. A standardized exercise test at the beginning of the rehabilitation program is recommended to facilitate appropriate prescription of exercise intensity.