FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 345:892-902 September 20, 2001 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Coronary heart disease is the leading cause of death in the United States among men and women.¹ It is also a major cause of physical disability, particularly in the rapidly growing population of elderly persons.^2,3 In 1997, acute myocardial infarction was diagnosed in 1.1 million Americans, and 800,000 patients underwent coronary revascularization.¹ The prevention of subsequent coronary events and the maintenance of physical functioning in such patients are major challenges in preventive care.

Cardiac-rehabilitation programs were first developed in the 1960s,^4,5,6 once the benefits of ambulation during prolonged hospitalization for coronary events had been recognized.⁷ After discharge from the hospital, . . . [Full Text of this Article]

Exercise Intolerance and Disability in Patients with Coronary Heart Disease

Exercise Training

Safety

Effects on Exercise Tolerance, Symptoms, and Coronary Events

Effects on Coronary Risk Factors

Prescription of Exercise

            Case 1

            Case 2

Compliance

Comprehensive Risk Reduction

Smoking

Dyslipidemia

Excess Weight

Hypertension and Diabetes

Psychological Factors

Models of Cardiac Rehabilitation

Cost Effectiveness of Cardiac Rehabilitation

Challenges and Conclusions

Source Information

From the Department of Medicine, Division of Cardiology, University of Vermont College of Medicine and Fletcher Allen Health Care, Burlington.

Address reprint requests to Dr. Ades at McClure 1, Cardiology, Fletcher Allen Health Care, MCHV Campus, Burlington, VT 05401, or at philip.ades@vtmednet.org.

References

This article has been cited by other articles:

• Pluss, C E., Karlsson, M R., Wallen, N., Billing, E., Held, C. (2008). Effects of an expanded cardiac rehabilitation programme in patients treated for an acute myocardial infarction or a coronary artery by-pass graft operation. Clin Rehabil 22: 306-318 [Abstract]  
• Linden, W., Phillips, M. J., Leclerc, J. (2007). Psychological treatment of cardiac patients: a meta-analysis. Eur Heart J 28: 2972-2984 [Abstract] [Full Text]  
• Dobbels, F. (2007). Does every cardiologist need a psychologist?. Eur Heart J 28: 2964-2966 [Full Text]  
• Scholz, U., Sniehotta, F. F., Burkert, S., Schwarzer, R. (2007). Increasing Physical Exercise Levels: Age-Specific Benefits of Planning. J Aging Health 19: 851-866 [Abstract]  
• Hevey, D., McGee, H. M., Horgan, J. (2007). Relationship of Initial Level of Distress to Changes in Health-Related Quality of Life During Cardiac Rehabilitation or Usual Care. Psychosom. Med. 69: 793-797 [Abstract] [Full Text]  
• Carrero, J. J., Fonolla, J., Marti, J. L., Jimenez, J., Boza, J. J., Lopez-Huertas, E. (2007). Intake of Fish Oil, Oleic Acid, Folic Acid, and Vitamins B-6 and E for 1 Year Decreases Plasma C-Reactive Protein and Reduces Coronary Heart Disease Risk Factors in Male Patients in a Cardiac Rehabilitation Program. J. Nutr. 137: 384-390 [Abstract] [Full Text]  
• Sriskantharajah, J., Kai, J. (2007). Promoting physical activity among South Asian women with coronary heart disease and diabetes: what might help?. Fam Pract 24: 71-76 [Abstract] [Full Text]  
• Ignarro, L. J., Balestrieri, M. L., Napoli, C. (2007). Nutrition, physical activity, and cardiovascular disease: An update. Cardiovasc Res 73: 326-340 [Abstract] [Full Text]  
• Lavie, C. J., Milani, R. V. (2006). Adverse psychological and coronary risk profiles in young patients with coronary artery disease and benefits of formal cardiac rehabilitation.. Arch Intern Med 166: 1878-1883 [Abstract] [Full Text]  
• Giallauria, F., Lucci, R., Pietrosante, M., Gargiulo, G., De Lorenzo, A., D'Agostino, M., Gerundo, G., Abete, P., Rengo, F., Vigorito, C. (2006). Exercise-based cardiac rehabilitation improves heart rate recovery in elderly patients after acute myocardial infarction.. J. Gerontol. A Biol. Sci. Med. Sci. 61: 713-717 [Abstract] [Full Text]  
• Defoor, J., Martens, K., Zielinska, D., Matthijs, G., Van Nerum, H., Schepers, D., Fagard, R., Vanhees, L. (2006). The CAREGENE study: polymorphisms of the {beta}1-adrenoceptor gene and aerobic power in coronary artery disease. Eur Heart J 27: 808-816 [Abstract] [Full Text]  
• Evans, J. A., Bethell, H. J. N., Turner, S. C. (2006). NSF for CHD: 3 years of 12-month follow-up audit after cardiac rehabilitation. J Public Health (Oxf) 28: 35-38 [Abstract] [Full Text]  
• Rozanski, A., Blumenthal, J. (2006). Cardiac Rehabilitation, Exercise Training, and Psychosocial Risk Factors: Reply. J Am Coll Cardiol 47: 212-213 [Full Text]  
• Rozanski, A., Blumenthal, J. (2005). Cardiac Rehabilitation, Exercise Training, and Psychosocial Risk Factors: REPLY. J Am Coll Cardiol 0: j.jacc.2005.10.003v1-11500 [Full Text]  
• King, M. L., Williams, M. A., Fletcher, G. F., Gordon, N. F., Gulanick, M., King, C. N., Leon, A. S., Levine, B. D., Costa, F., Wenger, N. K. (2005). Medical Director Responsibilities for Outpatient Cardiac Rehabilitation/Secondary Prevention Programs: A Scientific Statement From the American Heart Association/American Association for Cardiovascular and Pulmonary Rehabilitation. Circulation 112: 3354-3360 [Full Text]  
• Fletcher, B., Berra, K., Ades, P., Braun, L. T., Burke, L. E., Durstine, J. L., Fair, J. M., Fletcher, G. F., Goff, D., Hayman, L. L., Hiatt, W. R., Miller, N. H., Krauss, R., Kris-Etherton, P., Stone, N., Wilterdink, J., Winston, M. (2005). Managing Abnormal Blood Lipids: A Collaborative Approach. Circulation 112: 3184-3209 [Abstract] [Full Text]  
• Thompson, P. D. (2005). Exercise Prescription and Proscription for Patients With Coronary Artery Disease. Circulation 112: 2354-2363 [Full Text]  
• Tsai, S.-W., Lin, Y.-W., Wu, S.-K. (2005). The effect of cardiac rehabilitation on recovery of heart rate over one minute after exercise in patients with coronary artery bypass graft surgery. Clin Rehabil 19: 843-849 [Abstract]  
• Rozanski, A., Blumenthal, J. A., Davidson, K. W., Saab, P. G., Kubzansky, L. (2005). The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: The emerging field of behavioral cardiology. J Am Coll Cardiol 45: 637-651 [Abstract] [Full Text]  
• Leon, A. S., Franklin, B. A., Costa, F., Balady, G. J., Berra, K. A., Stewart, K. J., Thompson, P. D., Williams, M. A., Lauer, M. S. (2005). Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease: An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 111: 369-376 [Abstract] [Full Text]  
• Gluckman, T. J., Sachdev, M., Schulman, S. P., Blumenthal, R. S. (2005). A Simplified Approach to the Management of Non-ST-Segment Elevation Acute Coronary Syndromes. JAMA 293: 349-357 [Abstract] [Full Text]  
• Twardella, D., Kupper-Nybelen, J., Rothenbacher, D., Hahmann, H., Wusten, B., Brenner, H. (2004). Short-term benefit of smoking cessation in patients with coronary heart disease: estimates based on self-reported smoking data and serum cotinine measurements. Eur Heart J 25: 2101-2108 [Abstract] [Full Text]  
• Witt, B. J., Jacobsen, S. J., Weston, S. A., Killian, J. M., Meverden, R. A., Allison, T. G., Reeder, G. S., Roger, V.e. L. (2004). Cardiac rehabilitation after myocardial infarction in the community. J Am Coll Cardiol 44: 988-996 [Abstract] [Full Text]  
• Gluckman, T. J., Baranowski, B., Ashen, M. D., Henrikson, C. A., McAllister, M., Braunstein, J. B., Blumenthal, R. S. (2004). A Practical and Evidence-Based Approach to Cardiovascular Disease Risk Reduction. Arch Intern Med 164: 1490-1500 [Abstract] [Full Text]  
• Vanhees, L., Kornaat, M., Defoor, J., Aufdemkampe, G., Schepers, D., Stevens, A., van Exel, H., van den Beld, J., Heidbuchel, H., Fagard, R. (2004). Effect of exercise training in patients with an implantable cardioverter defibrillator. Eur Heart J 25: 1120-1126 [Abstract] [Full Text]  
• Dalal, H., Evans, P. H, Campbell, J. L (2004). Recent developments in secondary prevention and cardiac rehabilitation after acute myocardial infarction. BMJ 328: 693-697 [Full Text]  
• Young, W., Rewa, G., Goodman, S. G., Jaglal, S. B., Cash, L., Lefkowitz, C., Coyte, P. C. (2003). Evaluation of a community-based inner-city disease management program for postmyocardial infarction patients: a randomized controlled trial. CMAJ 169: 905-910 [Abstract] [Full Text]  
• Giannuzzi, P., Saner, H., Bjornstad, H., Fioretti, P., Mendes, M., Cohen-Solal, A., Dugmore, L., Hambrecht, R., Hellemans, I., McGee, H., Perk, J., Vanhees, L., Veress, G. (2003). Secondary Prevention Through Cardiac Rehabilitation: Position Paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology. Eur Heart J 24: 1273-1278 [Abstract] [Full Text]  
• Jain, A, Wadehra, V, Timmis, A D (2003). Management of stable angina. Postgrad. Med. J. 79: 332-336 [Abstract] [Full Text]  
• Willey, K. A., Singh, M. A. F. (2003). Battling Insulin Resistance in Elderly Obese People With Type 2 Diabetes: Bring on the heavy weights. Diabetes Care 26: 1580-1588 [Abstract] [Full Text]  
• Dalal, H. M, Evans, P. H (2003). Achieving national service framework standards for cardiac rehabilitation and secondary prevention. BMJ 326: 481-484 [Abstract] [Full Text]  
• Weil, E., Wachterman, M., McCarthy, E. P., Davis, R. B., O'Day, B., Iezzoni, L. I., Wee, C. C. (2002). Obesity Among Adults With Disabling Conditions. JAMA 288: 1265-1268 [Abstract] [Full Text]  
• Krumholz, H. M., Weintraub, W. S., Bradford, W. D., Heidenreich, P. A., Mark, D. B., Paltiel, A. D. (2002). Task Force #2--the cost of prevention: can we afford it? Can we afford not to do it?. J Am Coll Cardiol 40: 603-615 [Full Text]  
• Ades, P. A., Kottke, T. E., Houston Miller, N., McGrath, J. C., Record, N. B., Record, S. S. (2002). Task Force #3--getting results: who, where, and how?. J Am Coll Cardiol 40: 615-630 [Full Text]  
• Micevski, V. (2002). Review: multidisciplinary disease management programmes do not reduce death or recurrent myocardial infarction but reduce admission to hospital. Evid. Based Nurs. 5: 54-54 [Full Text]  
• van Houten, C D, Angenot, E L., Lankhorst, G J, Deville, W, Beckerman, H (2002). Functional recovery after cardiac rehabilitation. Clin Rehabil 16: 338-342 [Abstract]  
• Perrone-Filardi, P., Chiariello, M. (2002). Coronary artery disease and intermittent claudication: how to manage the patient. Eur Heart J Suppl 4: B58-B62 [Abstract]  
• Bankier, B., Littman, A. B., Rees, K., Ebrahim, S., the Cochrane Heart Group, , Ades, P. A. (2002). Cardiac Rehabilitation. NEJM 346: 379-380 [Full Text]