Understanding Cardiac Rehabilitation

According to the 2016 China Cardiovascular Disease Report, China has 290 million active cardiovascular patients, with cardiovascular disease mortality ranking first, accounting for more than 40% of the population’s disease mortality composition. Despite the fact that blood flow reconstruction and drug therapy can improve the prognosis, there is still a high incidence of cardiovascular events. How to enable patients with cardiovascular disease to return to normal life and work, avoid recurrence of cardiovascular events, and improve quality of life is one of the most researched topics in clinical medicine today. Exercise rehabilitation and secondary prevention are flourishing in developed countries and have become important adjuncts to post-PCI treatment. Studies have shown that cardiac rehabilitation can improve patients’ quality of life and reduce cardiovascular events. I. What is cardiac rehabilitation? Cardiac rehabilitation refers to the application of a variety of coordinated, purposeful interventions, including rehabilitation assessment, exercise training, guidance on diet, guidance on lifestyle habits, regular medication taking, regular monitoring of indicators and health education, etc., so that patients can improve their quality of life, return to normal social life and prevent cardiovascular events. Phase I: Acute phase (hospitalization) 4-7 days after the onset of the disease, with the goal of life safety and return to normal life. 2. Phase II: Recovery phase (outpatient) 7 days-6 months after the onset of the disease, with the goal of reinstatement and return to society. 3. 3. Five core prescriptions for cardiac rehabilitation Based on the overall medical assessment, the joint intervention of five core prescriptions (drug prescription, exercise prescription, nutrition prescription, psychological prescription and smoking cessation prescription) can provide physiological, psychological and social management services and services for cardiovascular disease patients in the acute, recovery and maintenance periods and throughout the life course. We provide comprehensive and total management services and care for patients with cardiovascular disease in the acute, recovery, maintenance and throughout the life course. Medication is the core part of cardiovascular disease treatment and an important guarantee for cardiac rehabilitation. The current situation of secondary prevention medication for patients with coronary heart disease in China is not ideal. Some patients subjectively do not pay attention to taking medication due to lack of understanding of the disease; or there is anxiety or depression, worrying about the side effects of medication and stopping or adjusting the medication by themselves. Patients with coronary artery disease should adhere to secondary prevention medications that are individually adjusted by physicians. An optimized medication regimen can effectively reduce the occurrence of acute cardiovascular events and improve long-term prognosis. 2.Exercise prescription Physical exercise has a long history in China. Boxing, qigong, martial arts, music and dance and other sports have a unique style of combining motion and static, rigidity and flexibility. On the one hand, through activities or postures, together with whistling and intention, they can achieve smooth qi flow, strengthen muscles and bones, harmonize internal organs, and promote recovery and compensation of body functions; on the other hand, through consciousness, they can achieve relaxation of the body, coordination of whistling, and tranquilization of the mind, promote adaptation and regulation of disease in the early stage of disease recovery and severe dysfunction, and accelerate the recovery process, which is especially suitable for patients with chronic diseases and weaknesses. A randomized clinical trial published in the American Heart Journal in 2015 showed the safety and effectiveness of Tai Chi as an exercise intervention for cardiovascular disease. 3. Nutritional prescriptions Mainly include controlling total caloric intake, controlling intake of high-fat and high-cholesterol foods, and reducing intake of sucrose and high-sugar foods. Encourage the intake of meat (such as poultry, fish, lean meat) and eggs with low fat content, among which fish contains more polyunsaturated fatty acids which are beneficial to the body and have positive significance on the prevention of cardiovascular diseases and dyslipidemia. We advocate a low-salt and light diet, reduce the intake of indigestible foods, eat more fresh vegetables and fruits rich in vitamins and legumes rich in vegetable proteins; eat fewer meals and minimize the intake of food for dinner; choose healthy oils (such as vegetable oils) as much as possible, etc. TCM rehabilitation has unique theoretical knowledge and proven practical experience in dietary management, and has been proven to be safe and effective by modern medical and clinical nutrition research. 4.Psychological prescription Mental factors have an important influence in the occurrence, development and regression of diseases, and mental intake plays a primary role in the process of disease recovery. A large number of patients with cardiovascular diseases have or both psychiatric and psychological problems. Due to the limitations of the traditional medical model, psychiatric and psychological factors are often neglected; on the one hand, patients themselves do not pay attention to psychological aspects, and on the other hand, professional psychotherapy has been mainly focused on psychiatric diseases and rarely provides professional help for general anxiety and depression. This has led to a significant reduction in clinical adherence, clinical prognosis and quality of life for patients with cardiovascular disease. 5, smoking cessation prescription Smoking cessation reduces the risk of cardiovascular disease morbidity and mortality. Studies have shown that the harmful components in tobacco promote the development of cardiovascular events mainly through the regulation of inflammatory factor pathways, promotion of lipid peroxidation and induction of abnormal vascular function. Smoking cessation reduces cardiovascular disease risk factors by about 1/3, and quitting for 4 years significantly reduces the incidence of myocardial infarction, stroke, and total cardiovascular events. The long-term benefits of smoking cessation are comparable to those of currently used secondary prevention medications for coronary heart disease, such as aspirin and statins, and it is the most cost-effective intervention for saving lives. As one of the most important measures in the primary and secondary prevention of coronary heart disease, smoking cessation has an excellent cost-benefit ratio. If there is a heavy weight on your chest that makes it hard or even painful, that’s when you’re willing to do anything. Many patients start cardiac rehabilitation doing well, but gradually feel better and think about how to slack off. It must be admitted that it is hard to stick with it, and for those who keep at it, the results must be amazing.