A heart rehab program beats exercise alone

Q. I had a heart attack a week ago. Fortunately, there was minimal damage, and I feel fine. My doctor wants me to go through a heart rehab program. Why can't I just exercise on my own?

A. After having a heart attack or heart surgery, one of the best things you can do for your heart and long-term health is to go through a cardiac rehabilitation program. Such programs have been shown to reduce deaths by up to 25 percent during the few years following the heart attack or procedure.

The results of a recently published study in the journal Circulation suggest that the reduced death rate might be as high as 50 percent for those who stick with the program.

The benefits of cardiac rehabilitation go beyond survival and heart health. These programs improve muscle strength, lung function and endurance, which are essential for returning to activity after heart surgery or an attack.

Yet barely 20 percent of people who are eligible for cardiac rehabilitation take part in a program. And, according to the article in Circulation, for those who did sign up, only 18 percent completed all 36 sessions that were paid for by insurance.

Cardiac rehab programs include:

*Exercise routines

*Psychological and social support

*Dietary and weight-loss counseling

*Support to help smokers quit and

*Stress reduction.

Anyone can sign up for a rehab program. The catch is, insurers will pay for it only for people who have:

*Undergone heart bypass surgery

*Had a heart attack

*Undergone angioplasty

*Coronary artery disease and angina (chest pain or other symptoms with physical activity)

*Undergone heart valve surgery or

*Undergone heart or lung transplant.

The standard exercise program centers around walking on a treadmill. You start with slow walking on a flat surface and increase speed. Resistance is added by walking on an incline. An exercise therapist monitors heart rate, blood pressure and oxygen level. Once you reach a comfortable level, you are ready for the maintenance phase. You could increase intensity, with shorter workouts, about 30 minutes 3 or 4 times a week.