Cardiac rehabilitation improves heart rate recovery, boosts survival

For the first time, researchers have discovered cardiac rehabilitation can train the heart to quickly return to its normal rate after exercise.

In a study reported in Circulation: Journal of the American Heart Association, researchers said heart disease patients with normal heart rate recovery live longer than those with slow heart rate recovery. A heart that returns to normal rate more quickly works better than one that stays revved up for a while.

"There's no medicine that can do that," said Leslie Cho, M.D., lead author of the study and director of the Women's Cardiovascular Center at the Cleveland Clinic in Ohio. "Especially in terms of mortality, if we had a medicine that could make this dramatic an impact, it would be the blockbuster drug of the century."

Heart rate recovery refers to the number of beats the heart rate decreases during the first minute after stopping exercise.

Researchers looked at 1,070 patients with various cardiovascular diseases who were referred for cardiac rehabilitation at the Cleveland Clinic. They measured heart rate recovery with an exercise stress test before and after 12 weeks of cardiac rehabilitation. A count of 12 beats or less was considered abnormal.

Among the 544 patients who started cardiac rehabilitation with abnormal heart rate recovery, 41 percent had normal heart rate recovery after 12 weeks. Of the 526 patients who started with normal heart rate recovery, 89 percent maintained it after cardiac rehabilitation.

The risk of dying within eight years more than doubled in patients whose heart rate recovery was abnormal after cardiac rehabilitation, even after adjusting for factors such as smoking history, weight and changes in the use of medications.

"There's not only mortality benefit from cardiac rehabilitation, but now we know why people benefit," said Cho, who is also section head of preventive cardiology and rehabilitation in the Department of Cardiovascular Medicine at the Cleveland Clinic.

Cardiac rehabilitation (rehab) is a medically supervised program that helps improve the health and well-being of people who have heart problems.

Rehab programs include exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life.

Cardiac rehab helps people who have heart problems

• Recover after a heart attack or heart surgery.
• Prevent future hospital stays, heart problems, and death related to heart problems.
• Address risk factors that lead to coronary heart disease (also called coronary artery disease) and other heart problems. These risk factors include high blood pressure, high blood cholesterol, overweight or obesity, diabetesexternal link icon, smoking, lack of physical activity, and depression and other emotional health concerns.