(Circulation. 2000;102:1069.)
© 2000 American Heart Association, Inc.
AHA/AACVPR Scientific Statement |
Core Components of Cardiac Rehabilitation/Secondary Prevention Programs
A Statement for Healthcare Professionals From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation Writing Group
Key Words: AHA/AACVPR Scientific Statement • prevention • cardiovascular diseases • diet • exercise • risk factors
Cardiac rehabilitation/secondary prevention programs are recognized as integral to the comprehensive care of patients with cardiovascular disease.1 2 In 1994, the American Heart Association stated that cardiac rehabilitation programs should consist of a multifaceted and multidisciplinary approach to overall cardiovascular risk reduction, and that programs that consist of exercise training alone are not considered cardiac rehabilitation.1 This concept has been further developed in the Agency for Health Care Policy and Research clinical practice guideline on cardiac rehabilitation,2 which provides the most comprehensive review of the scientific literature and evidence-based recommendations regarding all aspects of the discipline. The American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognize that all cardiac rehabilitation/secondary prevention programs should contain specific core components that aim to optimize cardiovascular risk reduction, foster healthy behaviors and compliance to these behaviors, reduce disability, and promote an active lifestyle for patients with cardiovascular disease.
The purpose of this statement is to present specific information regarding evaluation, intervention, and expected outcomes in each of the core components of cardiac rehabilitation/secondary prevention programs: baseline patient assessment; nutritional counseling; risk factor management (lipids, hypertension, weight, diabetes, and smoking); psychosocial management; physical activity counseling; and exercise training. These recommendations are intended to assist cardiac rehabilitation staff in the design and development of their programs and to assist healthcare providers, insurers and policy makers, and consumers in the recognition of the comprehensive nature of such programs. It is not the intent of this statement to promote a rote approach or homogeneity among programs, but rather to foster a foundation of services upon which each program can establish its own specific strengths and identity and effectively attain outcome goals for its target population. Comprehensive and detailed guidelines regarding cardiac rehabilitation/secondary prevention programs have been published by the AACVPR3 and endorsed by the American Heart Association. Detailed guidelines on specific risk factor modifications are also available.4 5 6 7 8 9 10 11 12 13 14 15 16 17 Specific details regarding management of patients with heart failure, valvular disease, arrhythmias, and other cardiovascular diagnoses are beyond the scope of this document and can be found in the AACVPR guidelines.3
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Footnotes
This statement was approved by the American Heart Association Science Advisory and Coordinating Committee in May 2000. A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0186. To purchase additional reprints: up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies, call 214-706-1466, fax 214-691-6342, or e-mail pubauth@heart.org. To make photocopies for personal or educational use, call the Copyright Clearance Center, 978-750-8400.
This statement is also being published in the September/October 2000 issue of the Journal of Cardiopulmonary Rehabilitation.
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