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(Circulation. 2007;116:1644-1646.)
© 2007 American Heart Association, Inc.

Editorial

Cardiac Rehabilitation/Secondary Prevention Programs

A Raft for the Rapids: Why Have We Missed the Boat?

Randal J. Thomas, MD, MS

From the Cardiovascular Health Clinic, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, and the Mayo Clinic College of Medicine, Rochester, Minn.

Correspondence to Randal J. Thomas, MD, MS, Cardiovascular Health Clinic, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail thomas. randal@mayo.edu

Key Words: Editorials • bypass • coronary disease • exercise • myocardial infarction • prevention

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 

"There are risks and costs to a program of action. But they are far less than the long-range risks and costs of comfortable inaction."

— John Fitzgerald Kennedy 1

Every year, hundreds of thousands of patients experience a coronary heart disease (CHD) event and enter a period of time that is high risk, life threatening, and life altering—the medical equivalent of a ride down the turbulent and dangerous whitewater-rapids portion of a river.² Fortunately, most patients survive these events, thanks in part to the prompt application of life-saving therapies in the home, ambulance, and hospital settings. However, for those patients who leave the hospital after a CHD event, the ride in the whitewater rapids has not ended. They remain at increased risk for future CHD events. Effective secondary prevention therapies are available in the posthospital setting, but unfortunately, some of those therapies, including cardiac rehabilitation/secondary prevention (CRSP) services, are underused.³ In fact, most patients who survive a CHD event do not receive CRSP services and can be compared with a group of people who are crossing the whitewater rapids of a river without a raft.

Article p 1653

In this issue of Circulation, Suaya and colleagues⁴ present a landmark study that helps increase our understanding of the underuse of CRSP services: its severity, causes, and potential solutions. In their study, the authors report that only 50 000 (18.7%) of 267 427 Medicare-eligible patients >65 years of age who experienced a CHD event (myocardial infarction or coronary artery bypass graft . . . [Full Text of this Article]

Related Article:

Issue Highlights
Circulation 2007 116: 1643. [Extract] [Full Text]

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