Changing clinical profile of patients entering cardiac rehabilitation/secondary prevention programs: 1996 to 2006

Cardiac rehabilitation (CR)/secondary prevention programming is dependent on clinical attributes of participants. We examined recent changes in the profile of individuals who are entering CR.

We analyzed data for all patients entering our phase II CR program from 1996 to 2006. Patients were classified into 5 groups on the basis of recruitment period: period 1 (1996-1998) (n = 604), period 2 (1999-2000) (n = 571), period 3 (2001-2002) (n = 588), period 4 (2003-2004) (n = 519), and period 5 (2005-2006) (n = 532).

From period 1 to period 5, age increased from 60.6 to 63.4 years, and the proportion of patients 75 years or older increased by 59%. The proportion of women, initially 25%, did not change. Weight increased from 84.7 to 88.5 kg, whereas the proportion of patients with obesity, diabetes, and hypertension increased by 35%, 52%, and 48%, respectively. However, the proportion of patients with elevated blood pressure level did not change significantly. Peak relative aerobic capacity decreased by 10%. Total cholesterol, triglycerides, and low-density lipoprotein cholesterol decreased by 20%, 35%, and 27%, respectively, whereas high-density lipoprotein cholesterol increased by 12%. Use of all evidence-based cardiovascular drugs increased significantly, particularly statins (from 25% to 77%).

CR participants are now older, more frequently present with features of the metabolic syndrome, and are relatively less fit. However, a 3-fold increase in statin use over 10 years has contributed to a marked improvement of lipid parameters.