“I Just Can't Do It Anymore”: Patterns of Physical Activity and Cardiac Rehabilitation Referral in African Americans with Heart Failure

2011 ◽  
Vol 17 (8) ◽  
pp. S5
Author(s):  
Margaret M. McCarthy ◽  
Alexandra Howe ◽  
Judith Schipper ◽  
Jaime Gonzalez ◽  
Stuart Katz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
African Americans ◽  
Cardiac Rehabilitation

Abstract MP013: Strong Inverse Relation between Physical Activity and Incidence of Cardiovascular Disease in African Americans: the Atherosclerosis Risk in Communities Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Elizabeth J Bell
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
African Americans ◽  
Risk Reduction ◽  
Atherosclerosis Risk In Communities ◽  
Baseline Visit ◽  
Atherosclerosis Risk

Introduction: Although there is substantial evidence that physical activity reduces risk of cardiovascular disease (CVD), the few studies that included African Americans offer inconclusive evidence and did not study stroke and heart failure separately. Objective: We examined, in African Americans and Caucasians in the Atherosclerosis Risk in Communities study (ARIC), the association of physical activity with CVD incidence (n=1,039) and its major components - stroke (n=350), heart failure (n=633), and coronary heart disease (n=442) - over a follow-up period of 21 years. Methods: ARIC is a population-based biracial cohort study of 45– to 64-yr-old adults at the baseline visit in 1987–89. Physical activity was assessed using the modified Baecke physical activity questionnaire and categorized by the American Heart Association’s ideal CVD health guidelines: poor, intermediate, and ideal physical activity. An incident CVD event was defined as the first occurrence of 1) heart failure, 2) definite or probable stroke, or 3) coronary heart disease, defined as a definite or probable myocardial infarction or definite fatal coronary heart disease. Results: We included 3,707 African Americans and 10,018 Caucasians free of CVD at the baseline visit. After adjustment for age, sex, cigarette smoking, alcohol intake, hormone therapy use, education, and ‘Western’ and ‘Prudent’ dietary pattern scores, higher physical activity was inversely related to CVD, heart failure, and coronary heart disease incidence in African Americans and Caucasians (p-values for trend tests <.0001), and with stroke in African Americans. Hazard ratios (95% confidence intervals) for CVD for intermediate and ideal physical activity, respectively, compared to poor, were similar by race: 0.65 (0.56, 0.75) and 0.59 (0.49, 0.71) for African Americans, and 0.74 (0.66, 0.83) and 0.67 (0.59, 0.75) for Caucasians (p-value for interaction = 0.38). Physical activity was also associated similarly in African Americans and Caucasians for each of the individual CVD outcomes (coronary heart disease, heart failure, and stroke), with an approximate one-third reduction in risk for intermediate and ideal physical activity versus poor physical activity- this reduction was statistically significant. Conclusions: In conclusion, our findings reinforce public health recommendations that regular physical activity is important for CVD risk reduction, including reductions in stroke and heart failure. They provide strong new evidence that this risk reduction applies to African Americans as well as Caucasians and support the idea that some physical activity is better than none.

scholarly journals Role and efficacy of cardiac rehabilitation in patients with heart failure

2019 ◽  
Vol 89 (1) ◽  
Author(s):  
Maria Teresa La Rovere ◽  
Egidio Traversi
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
High Risk ◽  
Cardiac Rehabilitation ◽  
Acute Decompensated Heart Failure ◽  
Care Service ◽  
Decompensated Heart Failure ◽  
The Elderly ◽  
Outpatient Basis ◽  
Patients With Heart Failure

Despite improvements in treatments, the prognosis of heart failure remains poor. Elderly patients with heart failure are burdened with multiple co-morbidities and polypharmacy. Multidisciplinary disease-management programs are recommended as standard care for patients at high risk of hospitalization. Cardiac rehabilitation is defined a coordinated multidimensional intervention that integrates the basic elements in multidisciplinary management programs with a continuing program of physical activity and exercise training. Cardiac rehabilitation services can be provided on an inpatient or outpatient basis according to the clinical characteristics and severity of the disease. Data support the usefulness of inpatient cardiac rehabilitation interventions soon after hospitalization for acute decompensated heart failure as a “transition care service” to overcome the particularly high risk “vulnerable” phase. Although in the elderly, physical activity is conditioned by the general clinical conditions, the presence of comorbidities and frailty, several data underscore the importance of improving exercise capacity in the elderly vulnerable patient.

scholarly journals Early Increased Physical Activity, Cardiac Rehabilitation, and Survival After Implantable Cardioverter-Defibrillator Implantation

2021 ◽  
Author(s):  
Brett D. Atwater ◽  
Zhen Li ◽  
Jessica Pritchard ◽  
Melissa A. Greiner ◽  
Yelena Nabutovsky ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Propensity Scores ◽  
Time Frame ◽  
Hazard Ratio ◽  
Implantable Cardioverter Defibrillators ◽  
Medicare Beneficiaries ◽  
Icd Implantation ◽  
All Cause Mortality

Background: Increased physical activity (PA) through cardiac rehabilitation (CR) improves outcomes in patients with heart failure and coronary disease, but CR referral remains infrequent. Implantable cardioverter-defibrillators (ICDs) can provide daily PA measurements to patients that may motivate them to increase PA, but it remains unclear if increased ICD measured PA is associated with improved outcomes with and without CR. Methods: This is a retrospective observational study of 41 731 Medicare beneficiaries with ICD implantation between January 1, 2014 and December 31, 2016. We linked daily ICD PA measurements and Medicare claims data to determine if increased PA is associated with a reduction in the likelihood of death or heart failure hospitalization. To determine if CR participation altered the effect of PA on outcomes, we performed two additional analyses matching CR participants and nonparticipants using propensity scores. The first match included demographics, comorbidities, and baseline PA measurements. The second match also included the change in PA measured during CR or the same time frame after ICD implant among nonparticipants. Results: The mean age was 75 (SD, 10) years, 30 182 beneficiaries (72.3%) were male, and 1324 (3%) participated in CR. Increased ICD detected PA was associated with improved survival. CR participants had a mean PA change of +9.7 (SD, 57.8) min/d, whereas nonparticipants had a mean change of −1.0 (SD, 59.7) min/d ( P <0.001). After matching for demographics, comorbidities and baseline PA, CR participants had significantly lower 1- to 3-year mortality (hazard ratio, 0.76 [95% CI, 0.69–0.85], P =0.03). After additionally matching for the ICD measured change in PA during CR there were no differences in mortality with and without CR (hazard ratio, 1.00 [95% CI, 0.82–1.21], P =0.87). Every 10 minutes of increased daily PA was associated with a 1.1% reduction in all-cause mortality in both groups. Conclusions: Among Medicare beneficiaries with ICDs, small increases in PA were associated with significant reductions in all-cause mortality.

Exercise capacity, physical activity patterns and outcomes six years after cardiac rehabilitation in patients with heart failure

2007 ◽  
Vol 21 (10) ◽  
pp. 923-931 ◽  
Author(s):  
Lionel Mueller ◽  
Jonathan Myers ◽  
Wilhard Kottman ◽  
Ulrike Oswald ◽  
Claudia Boesch ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Activity Patterns ◽  
Physical Activity Patterns ◽  
Patients With Heart Failure

scholarly journals Protective effect of physical activity on mortality in older adults with advanced chronic heart failure: A prospective observational study

2018 ◽  
Vol 26 (5) ◽  
pp. 481-488 ◽  
Author(s):  
Francesco Cacciatore ◽  
Cristiano Amarelli ◽  
Nicola Ferrara ◽  
Elisabetta Della Valle ◽  
Francesco Curcio ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Physical Activity Level ◽  
Hazard Rate ◽  
Nyha Class ◽  
Advanced Heart Failure ◽  
Activity Level ◽  
Heart Failure Decompensation

Objectives The objective of this study was to evaluate the effect on mortality of self-reported physical activity evaluated by the physical activity scale for the elderly (PASE) in elderly patients with advanced heart failure enrolled in a cardiac rehabilitation unit after heart failure decompensation (NYHA class IIIB). Methods The study prospectively enrolled 314 elderly patients (≥65 years) with heart failure in NYHA class IIIB (symptomatic with a recent history of dyspnoea at rest) consecutively admitted to cardiac rehabilitation between January 2010 and July 2011. Comprehensive geriatric assessment was performed. Physical activity was evaluated by PASE and stratified in tertiles (0–15, 16–75 and >75). Mortality was collected from September to October 2015 in 300 patients. Results The mean age was 74.5 ± 6.1 (range 65–89); 74.7% were men, 132 patients (44.0%) died during the follow-up (44.1 ± 20.7 months). Univariate analysis shows that physical activity level conducted before heart failure decompensation was inversely related to mortality (from 76.0% to 8.2%, P = 0.000). Multivariate analysis confirms that the PASE score predicts mortality independently of several demographic and clinical variables (hazard rate 0.987, 95% confidence interval (CI) 0.980–0.994, P = 0.000). Notably, when considering PASE 0–15 versus 16–75 score and PASE 0–15 versus > 75 score, the hazard rate is 4.06 (95% CI 1.67–9.84, P < 0.001) and 7.25 (95% CI 2.7–19.5, P < 0.001), respectively. Conclusions Physical activity level evaluated by the PASE score is inversely related to mortality in elderly patients with advanced heart failure confirming the reduction of mortality exerted by moderate physical activity in such patients.

scholarly journals Heart failure and promotion of physical activity before and after cardiac rehabilitation (HF‐aPProACH): a study protocol

2021 ◽  
Author(s):  
Marlou A.M. Limpens ◽  
Muhammed T. Gürgöze ◽  
Mattie J. Lenzen ◽  
Stefan Roest ◽  
Trudy Voortman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Study Protocol ◽  
Before And After ◽  
Promotion Of Physical Activity
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