Just one-third of Chinese acute coronary syndrome patients receive rehabilitation guidance

October 11, 2018, European Society of Cardiology
Credit: CC0 Public Domain

Just one-third of Chinese patients with acute coronary syndromes including heart attack receive cardiac rehabilitation guidance before discharge from hospital, according to research presented at the 29th Great Wall International Congress of Cardiology (GW-ICC). Only one in ten receive personalised advice.

GW-ICC 2018 is being held 11 to 14 October in Beijing, China. Visiting experts from the European Society of Cardiology (ESC) will present key messages from ESC guidelines.

Heart attacks are on the rise in China, and the World Bank estimates that around 16 million will occur in 2020. Cardiac can improve quality of life and help prevent second heart attacks, rehospitalisation, and premature death. Programmes should include advice on smoking cessation, exercise, diet, weight control, blood pressure control, stress management, and psychological support.

This study examined the proportion of patients in China with acute coronary syndromes including myocardial infarction (heart attack) and unstable angina who received guidance before discharge from hospital. It was conducted within the Improving Care for Cardiovascular Disease in China – Acute Coronary Syndrome (CCC-ACS) project, a nationwide registry and quality improvement programme of the Chinese Society of Cardiology and American Heart Association.

After excluding patients with incomplete demographic information (191) and those who died during hospitalisation (1,223), the study enrolled 62,227 patients with from 150 hospitals across China between November 2014 and June 2017. Cardiac rehabilitation guidance was defined as providing a health brochure or personalised rehabilitation plan.

Just one-third (32.8 percent) of patients received guidance before discharge, and only one in ten (9.7 percent) were given an individualised plan. Men were more likely to receive advice (33.6 percent) than women (30.6 percent). The rate of guidance provision declined with increasing age, with 34.0 percent of under-45s receiving advice, compared to 32.9 percent of 45–74 year-olds, and 31.9 percent of those aged 75 years and above.

Study author, Dr. Guoliang Hu, of the Beijing Institute of Heart, Lung and Blood Vessel Diseases, said: "Prior research has suggested that women and older patients may benefit most from rehabilitation. In our study, these groups were even less likely to receive advice and therefore targeted efforts are needed."

Contrary to expectations, patients with a history of (CHD) received advice less often (30.5 percent) than those with no CHD history (33.1 percent). However, patients who had a stent implanted to open clogged arteries after their attack received advice more often (35.1 percent) than those who did not get a stent (27.5 percent).

Dr. Hu said: "All need cardiac rehabilitation and talking to them before discharge is an effective way to encourage participation, but this is an emerging field in China. The first step towards improving provision is to increase clinician awareness about the benefits of discussing cardiac rehabilitation before patients go home, just as they prescribe discharge medications. China also needs a cardiac rehabilitation referral system, evidence-based programmes, and dedicated centres and teams."

Professor Dong Zhao, Chairperson of the Scientific Committee of GW-ICC 2018 and an author of the study, said: "The low proportion of patients who receive cardiac rehabilitation guidance, based on findings of this project, may reflect the fact that it is still not integrated into routine hospital-based care for these in China. Adding cardiac rehabilitation guidance as an indicator of quality of care and providing more effective training for cardiologists may improve the situation."

Professor Jian'an Wang, Deputy President, Chinese Society of Cardiology, said: "Although cardiac rehabilitation in China started late, it has entered a period of rapid evolution. Nearly 500 cardiac rehabilitation centres have been established in the past five years. On the basis of traditional dietetics, nutrition and kinematics such as Tai Chi, we are learning from the experience in developed countries and providing training. With the creation of professional rehabilitation teams and the support of medical insurance policies, cardiac rehabilitation in China will flourish in the future."

Professor Michel Komajda, a Past President of the ESC and course director of the ESC programme at GW-ICC 2018, said: "Patients who have a or unstable angina are at very high risk of another event. They need intensive advice to tackle unhealthy lifestyles, including poor quality diet, physical inactivity, and smoking, and often require medication to treat high blood pressure and cholesterol, and aspirin to prevent clot formation."

Explore further: Sex and race disparities in cardiovascular health could be reduced

Related Stories

Sex and race disparities in cardiovascular health could be reduced

April 10, 2018
Substantial sex and racial gaps exist for cardiac rehabilitation referral at hospital discharge, especially among females, African-Americans, Hispanic and Asian patients leading to less favorable outcomes and/or survival ...

24,000 female patients missing out on vital cardiac rehabilitation services

December 16, 2015
New research conducted by the University of York and the British Heart Foundation (BHF) indicates that more than 24,000 female heart patients are missing out on crucial rehabilitation, putting them at risk of further heart ...

Self-delivered cardiac rehabilitation programmes could benefit harder to reach communities

February 16, 2018
Self-delivered cardiac rehabilitation (CR) programmes could benefit some "harder to reach" members of society, new research by the University of York reveals.

Early rehab doesn't increase adverse events post-CABG

February 5, 2015
(HealthDay)—Early enrollment in cardiac rehabilitation does not increase major adverse event rates among patients who recently underwent open heart surgery, according to a study published in the Feb. 15 issue of The American ...

More than half of heart patients continue smoking after hospitalisation

April 23, 2018
More than half of heart patients continue smoking after hospitalisation, according to results of the EUROASPIRE V survey presented today at EuroPrevent 2018, a European Society of Cardiology congress.1 Nearly half of obese ...

Recommended for you

No sweat required: Team finds hypertension treatment that mimics effect of exercise

October 16, 2018
Couch potatoes rejoice—there might be a way to get the blood pressure lowering benefits of exercise in pill form.

New model suggests cuffless, non-invasive blood pressure monitoring possible using pulse waves

October 16, 2018
A large team of researchers from several institutions in China and the U.S. has developed a model that suggests it should be possible to create a cuffless, non-invasive blood pressure monitor based on measuring pulse waves. ...

Why heart contractions are weaker in those with hypertrophic cardiomyopathy

October 16, 2018
When a young athlete suddenly dies of a heart attack, chances are high that they suffer from familial hypertrophic cardiomyopathy (HCM). Itis the most common genetic heart disease in the US and affects an estimated 1 in 500 ...

Novel genetic study sheds new light on risk of heart attack

October 12, 2018
Loss of a protein that regulates mitochondrial function can greatly increase the risk of myocardial infarction (heart attack), Vanderbilt scientists reported Oct. 3 in the journal eLife.

Researchers say ritual for orthodox Jewish men may offer heart benefits

October 11, 2018
A pilot study led by researchers at the University of Cincinnati (UC) College of Medicine suggests Jewish men who practice wearing tefillin, which involves the tight wrapping of an arm with leather banding as part of daily ...

Markers of dairy fat consumption linked to lower risk of type two diabetes

October 10, 2018
Higher levels of biomarkers of dairy fat consumption are associated with a lower risk of developing type 2 diabetes, according to new research published today in PLOS Medicine. The study, in more than 60,000 adults, was undertaken ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.