More than half (59%) of patients eligible for life saving cardiac rehabilitation in Wales are taking it up, an increase of 8% since 2017, according to new figures released by the British Heart Foundation Cymru (BHF).
In Wales, only 31% of cardiac rehabilitation patients are women, compared to 69% of men according to the figures, published today in the charity’s National Audit of Cardiac Rehabilitation (NACR) report. The NHS in Wales wants to ensure that all people with heart disease can, and do, access good quality rehabilitation.
Cardiac rehabilitation has been proven to reduce a patient’s chances of further complications after a heart event, and has been shown to reduce the risk of dying from heart and circulatory diseases by 26%. Cardiac rehab also decreases hospital admissions by around 20% and leads to improvements in quality of life.
Even if they are attending cardiac rehabilitation, women are not reaping the same benefits as men. They are less likely to improve their physical fitness and meet target levels for cholesterol and alcohol intake following rehabilitation, according to the report. BHF Cymru says this is, in-part, because programmes historically offer group based rehab in a community setting which has been shown to be less attractive to women.
Gillian Jones from Ynysbwl in Rhondda Cynon Taf, is attending a cardiac rehabilitation programme in Llantrisant. Gillian said:
“I was diagnosed with aortic stenosis in March 2017. Following a Dynamic Stress Echocardiogram in the Heath Hospital on the 26 June 2018 I was operated on the 31 July 2018. I had a replacement aortic valve and a double bypass. It came as a shock to me and my family as I’ve always been active. I’ve never smoked, I’m not overweight and I have a good diet. I’m extremely grateful for all the support I’ve had and can’t praise the nurses who run my cardiac rehab enough. I’ve thoroughly enjoyed the classes which have helped me to understand my condition and given me great advice on my medication, lifestyle and exercise. I’m part of a lovely group, and the nurses are practical and friendly. They’ve explained things I didn’t understand and are really reassuring. I’m one of only three women attending my cardiac rehab, the rest are men, but I feel really looked after and I would recommend the programme to anyone who needs it.”
Cardiac rehab is recommended for people after a heart attack, coronary angioplasty and heart surgery. It should also be available to some people with angina or heart failure. Programmes aim to help patients understand their condition and recover from surgery by providing lifestyle advice to improve physical and psychological health – such as advice on eating healthily and exercise.
The report highlighted that evidence from clinical trials suggests that cardiac rehab can be delivered successfully through different approaches focused around the person rather than the service, such as through a digital or home-based programmes.
BHF Cymru believes that offering such a solution will increase the number of people entering cardiac rehab over the next few years, and will increase uptake among underrepresented groups such as women and people from deprived and ethnic minority backgrounds.
Adam Fletcher, Head of BHF Cymru, said:
“We need to radically rethink how life saving follow-up care is delivered. The current cardiac rehabilitation offer is not meeting the needs of women, robbing them of the chance to receive urgent aftercare. Patients need to be able to access help in an easy and accessible way – be that in a group setting, in their own homes or through online services.
“Redesigning cardiac rehabilitation could save thousands more lives each year and save the NHS money. But in the meantime, if you know someone who has been offered cardiac rehab, please encourage them to take it up. It could, quite literally, save their life.”
Patrick Doherty, Professor of Cardiovascular Health at York University and lead author for the NACR, said:
“These figures should be of concern to all heart patients, regardless of gender. Cardiac rehabilitation can be the difference between life and death. It could be the difference between your wife, mother, sister or daughter living a fulfilled life or struggling from the after-effects of a heart attack. It’s clear that cardiac rehabilitation is a highly effective intervention but we need to ensure it works for everyone. Adopting and promoting a digitalised approach, as part of the cardiac rehab offer, would put the patient at the forefront of the treatment. Not everybody benefits from the same form of rehabilitation, and it is imperative that these programmes reflect this.”