Korean J Fam Pract 2020; 10(6): 448-455  https://doi.org/10.21215/kjfp.2020.10.6.448
The Correlations between the Number of Cardiac Rehabilitation Program Participation and Its Effects
Min-Young Jung1, Hye-Ran Choi2, Jung-Min Ahn3,*
1Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine; 2Department of Clinical Nursing, University of Ulsan College of Medicine; 3Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Jung-Min Ahn
Tel: +82-2-3010-3995, Fax: +82-2-475-6898
E-mail: drjmahn@gmail.com
ORCID: https://orcid.org/0000-0003-4031-391X
*본 논문은 1저자 정민영의 석사 학위 논문을 수정, 보완한 것입니다.
Received: July 20, 2020; Revised: November 10, 2020; Accepted: November 22, 2020; Published online: December 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: There is no previous study analyzing the direct relationship between the number of cardiac rehabilitation programs (CRP) attended and their effect.
Methods: We reviewed the data of 144 patients with cardiovascular disease who participated in CRPs and completed the pre- and post-program evaluation. We collected data on the blood pressure (BP), body composition, maximum consumption of oxygen (VO2 max) by exercise test, and serum lipid levels. We compared the results of the pre- and post-program variables and analyzed correlations between the program participation number and the differences in the pre- and post-program data. Then, we performed subgroup analysis based on the program participation number (1–3, 4–10, 11–15, 16 and more).
Results: All data significantly differed after the program, except for the VO2 max and triglyceride level. On correlation analysis, pre-post changes in body weight (BW), body mass index (BMI), body fat mass (BFM), and body fat percentage (BFP) showed a significant negative correlation with the program participation number. In the subgroup analysis, systolic blood pressure (SBP) and pulse rate (PR) significantly decreased in the first group. Body muscle mass increased while BFM, BFP, total cholesterol, and low-density lipoprotein cholesterol levels decreased in the second group. PR, BW BMI, BFM, and BFP decreased in the third group. SBP, PR, BFM, and BFP decreased and high-density lipoprotein cholesterol levels increased in the fourth group.
Conclusion: There are significant differences in cardiovascular risk factors after CRP. In addition, the participation number of CRPs shows significant correlation with its effects.
Keywords: Cardiac Rehabilitation; Cardiovascular Diseases; Correlation of Data; Body Composition; Cholesterol; Exercise Test
  1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation 2013; 127: e6-245.
  2. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006; 3: e442.
    Pubmed KoreaMed CrossRef
  3. Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation 2011; 123: e18-209.
  4. Kones R, Rumana U. Prevention of cardiovascular disease: updating the immensity of the challenge and the role of risk factors. Hosp Pract (1995) 2014;42: 92-100.
    Pubmed CrossRef
  5. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111: 369-76.
    Pubmed CrossRef
  6. Wenger NK. Current status of cardiac rehabilitation. J Am Coll Cardiol 2008; 51: 1619-31.
    Pubmed CrossRef
  7. Shephard RJ, Franklin B. Changes in the quality of life: a major goal of cardiac rehabilitation. J Cardiopulm Rehabil 2001; 21: 189-200.
    Pubmed CrossRef
  8. Pack QR, Goel K, Lahr BD, Greason KL, Squires RW, Lopez-Jimenez F, et al. Participation in cardiac rehabilitation and survival after coronary artery bypass graft surgery: a community-based study. Circulation 2013; 128: 590-7.
    Pubmed CrossRef
  9. Martin BJ, Arena R, Haykowsky M, Hauer T, Austford LD, Knudtson M, et al. Cardiovascular fitness and mortality after contemporary cardiac rehabilitation. Mayo Clin Proc 2013; 88: 455-63.
    Pubmed CrossRef
  10. Menezes AR, Lavie CJ, Milani RV, Forman DE, King M, Williams MA. Cardiac rehabilitation in the United States. Prog Cardiovasc Dis 2014; 56: 522-9.
    Pubmed CrossRef
  11. Martin BJ, Hauer T, Arena R, Austford LD, Galbraith PD, Lewin AM, et al. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients. Circulation 2012; 126: 677-87.
    Pubmed CrossRef
  12. Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation 2010; 121: 63-70.
    Pubmed KoreaMed CrossRef
  13. Weber KT, Janicki JS, McElroy PA, Reddy HK. Concepts and applications of cardiopulmonary exercise testing. Chest 1988; 93: 843-7.
    Pubmed CrossRef
  14. Goraya TY, Jacobsen SJ, Pellikka PA, Miller TD, Khan A, Weston SA, et al. Prognostic value of treadmill exercise testing in elderly persons. Ann Intern Med 2000; 132: 862-70.
    Pubmed CrossRef
  15. Spin JM, Prakash M, Froelicher VF, Partington S, Marcus R, Do D, et al. The prognostic value of exercise testing in elderly men. Am J Med 2002; 112:453-9.
  16. Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med 2001; 345: 892-902.
    Pubmed CrossRef
  17. Banz WJ, Maher MA, Thompson WG, Bassett DR, Moore W, Ashraf M, et al. Effects of resistance versus aerobic training on coronary artery disease risk factors. Exp Biol Med (Maywood) 2003; 228: 434-40
    Pubmed CrossRef
  18. Maines TY, Lavie CJ, Milani RV, Cassidy MM, Gilliland YE, Murgo JP. Effects of cardiac rehabilitation and exercise programs on exercise capacity, coronary risk factors, behavior, and quality of life in patients with coronary artery disease. South Med J 1997; 90: 43-9.
    Pubmed CrossRef
  19. Brady S, Purdham D, Oh P, Grace S. Clinical and sociodemographic correlates of referral for cardiac rehabilitation following cardiac revascularization in Ontario. Heart Lung 2013; 42: 320-5.
    Pubmed CrossRef
  20. Thomas RJ, King M, Lui K, Oldridge N, Piña IL, Spertus J, et al. AACVPR/ACC/AHA 2007 performance measures on cardiac rehabilitation for referral to and delivery of cardiac rehabilitation/secondary prevention services endorsed by the American College of Chest Physicians, American College of Sports Medicine, American Physical Therapy Association, Canadian Association of Cardiac Rehabilitation, European Association for Cardiovascular Prevention and Rehabilitation, Inter-American Heart Foundation, National Association of Clinical Nurse Specialists, Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons. J Am Coll Cardiol 2007; 50: 1400-33.
    Pubmed CrossRef
  21. Goto Y, Saito M, Iwasaka T, Daida H, Kohzuki M, Ueshima K, et al. Poor implementation of cardiac rehabilitation despite broad dissemination of coronary interventions for acute myocardial infarction in Japan: a nationwide survey. Circ J 2007; 71: 173-9.
    Pubmed CrossRef

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