SHOULD ALL CARDIAC PATIENTS BE OFFERED THE CHOICE OF CARDIAC REHABILITATION

Objective, To determine whether cardiac rehabilitation services are be neficial to patients and cost-effective, Design, Several recent public ations are reviewed, The first of these, 'Cardiac Rehabilitation, Clin ical Practice Guideline No, 17', is itself a review of original publis hed research: 900 scientific reports were examined by a multidisciplin ary panel and 334 of these were considered to be of sufficient scienti fic merit to be used as the references for the guideline, The other pu blications discussed are: The American Heart Association Consensus Pan el Statement, 'Preventing heart attack and death in patients with coro nary disease', the American College of Cardiology's recommendations on 'Matching the intensity of risk factor management with the hazard for coronary disease events' and Recommendations of the Task Force of the European Society of Cardiology, the European Atherosclerosis Society and European Society of Hypertension, 'Prevention of coronary heart di sease in clinical practice', Results. Cardiac rehabilitation brought a bout substantial benefits in risk factor profiles, including improveme nt in exercise tolerance, blood lipids, psychosocial well-being, and r eduction in cigarette smoking and stress levels, In addition there was well-documented proof of improvement of pathophysiological measures, such as relief of symptoms, less progression and greater regression of disease and a reduction in mortality, As an intervention, cardiac reh abilitation,vas shown to be as cost-effective as many pharmacological regimens and surgical interventions, Conclusion, The evidence in suppo rt of cardiac rehabilitation is so overwhelming that all patients shou ld be educated about this form of treatment and have the ultimate choi ce of accepting or rejecting it.