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Updated: Aug 6, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
The Extensive Lifestyle Management Intervention (ELMI) after cardiac rehabilitation: a 4-year randomized controlled
Scott A Lear1, John J Spinelli, Wolfgang Linden
1School of Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada. slear@providencehealth.bc.ca
Insights
A modest intervention after cardiac rehabilitation significantly reduced cardiovascular risk. This approach improved Framingham risk scores, cholesterol, and blood pressure compared to usual care over four years.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Cardiovascular risk factors and lifestyle behaviors often worsen post-cardiac rehabilitation program (CRP).
- A need exists for effective interventions to sustain cardiovascular health after CRP completion.
Purpose of the Study:
- To evaluate if a modest risk factor and lifestyle management intervention post-CRP reduces cardiovascular risk.
- To compare the Framingham risk score after 4 years between an intervention group and a usual care group.
Main Methods:
- 302 patients with ischemic heart disease were randomized post-CRP to usual care or an intervention group.
- The intervention included exercise, telephone follow-ups, and counseling.
- Outcomes measured included Framingham risk score, risk factors, and lifestyle behaviors at 4 years.
Main Results:
- The intervention group (130 participants) showed significant improvements in Framingham risk score, total cholesterol, LDL cholesterol, and systolic blood pressure.
- The usual care group (119 participants) did not show similar improvements.
- No significant differences in lifestyle factors were observed between the groups.
Conclusions:
- A modest post-CRP intervention significantly reduces global cardiovascular risk.
- This intervention should be considered as a follow-up to standard cardiac rehabilitation programs.
Background:
Previous reports indicate risk factors and lifestyle behaviors may deteriorate early after completion of a cardiac rehabilitation program (CRP). We hypothesized that a modest risk factor and lifestyle management intervention after a CRP would significantly reduce overall cardiovascular risk using the Framingham risk score compared with usual care after 4 years.
Methods:
Patients with ischemic heart disease (n = 302) were randomized after a CRP to either usual care or intervention (exercise sessions, telephone follow-ups, counseling sessions, and reports to the participants' family physicians). The Framingham risk score, risk factors, and lifestyle behaviors were compared after 4 years.
Results:
Data were available for 130 intervention and 119 usual care participants. The intervention resulted in 15.5 hours of direct participant contact. Framingham score, total cholesterol, low-density lipoprotein cholesterol, and systolic blood pressure were significantly improved in the intervention group after adjusting for baseline factors. There were no significant differences with respect to lifestyle factors between the groups.
Conclusions:
A modest risk factor and lifestyle management intervention resulted in a significant reduction to global risk compared with usual care and should be considered after CRP.
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