MINNEAPOLIS. June 4, 2008—People recovering from heart attacks and heart surgery are more likely to develop healthy heart habits when they meet regularly with cardiac "disease managers," according to researchers at Mayo Clinic.

These "coaches" are nonphysician cardiac rehabilitation specialists who lead long-term follow-up programs that last three years. Once these risk factors come under control, heart patients live longer and have fewer heart problems.

The Mayo researchers studied the effects of a long-term cardiac disease manager model on 503 patients involved in cardiac rehabilitation. Their findings appear in The Journal of Cardiopulmonary Rehabilitation and Prevention.

The disease manager's role was to monitor the patient's status, and to coach the patients in adopting heart attack prevention behaviors. At each meeting, the following factors were assessed and management strategies were discussed: blood lipid levels, blood pressure and body weight, tobacco use, cardiac medication compliance, exercise regimen and physical activity, nutrition and cardiopulmonary symptoms.

After initial rehabilitation training about risk factor management, each patient met with a trained disease manager every three to six months for three years.

Their report demonstrates:

• It is feasible to provide long-term disease management to heart patients in an outpatient setting.
• The coaching approach increased the ampunt of exercise patients did, taking their medications, taking aspirin daily and lowering cholesterol levels and blood pressure.
• Patients experienced a lower death rate than uncoached heart patients.

Being overweight remains a prevalent and persistent risk factor for heart attack. As measured by body mass index, being overweight was the one heart disease risk factor that did not respond well to this disease manager approach. Other studies also have shown body weight to be the most change-resistant variable in efforts to promote heart health.

Mayo Clinic news release