The complications of cardiovascular disease are varied and require proper management by patients and doctors alike, and there are often misconceptions on what appropriate and health-centric cardiovascular care can be.
The American Society For Preventative Cardiology (ASPC) 2021 Virtual Summit assembled a diverse array of doctors, health care professionals, and public speakers to create a dialogue on progressive strategies and advancements made in the world of cardiology.
In an interview with HCPLive, Dr. Pam Taub, MD, FACC, FASPC, Professor of Medicine Director of Step Family Cardiovascular Rehabilitation and Wellness Center, spoke of the themes associated with her ASPC presentation “Physical Disabilities- Focus on Risk Assessment, Diet, Accessibility – How To Overcome Unique Challenges”.
Taub urged health care professionals and patients alike to consider the lifestyle approaches that are associated with cardiovascular disease. In many cases, the best strategies involve a combination of medication and physical exertion.
While conversations surrounding multi-layered management might be difficult, they are necessary.
“In addition to pharmacologic approaches, it’s always easier to tell a patient to take a drug and to add drugs as to adjust parameters such as lipids, blood pressure,” Taub said. “However, it’s much harder to talk to a patient about lifestyle strategies. For instance, exercise, what is the right types of things to be adding to their diet, those kinds of strategies.”
While pharmacologic therapies are often warranted, Taub found that patients received the most benefits when it was coupled with healthy lifestyle modifications.
Taub considered cardiac rehabilitation to be an important but “very underused” lifestyle-based program in the United States and the world at large. Traditionally, these types of programs are recommended to patients after they’ve had a cardiac event.
If a patient were to have a myocardial infraction or bypass surgery, an acceptable form of cardiac rehabilitation could be a valve replacement, resulting in improved exercise capacity and a reduction in rehospitalizations and overall mortality.
“In patients with physical disabilities are frail and elderly patients, they’re often dismissed as not being able to benefit from cardiac rehabilitation, because there’s this conventional view that in order to benefit from cardiac rehabilitation, you have to get on a treadmill and you have to be able to exercise,” Taub said. “But there’s a lot of things that we can do with these patients that don’t involve getting on a treadmill.”
Physical activities such as aerobic exercise can be implemented in the daily routines of older patients to build skeletal muscle and improve their quality of life.
Taub clarified that the health care community should not dismiss people with physical disabilities, as they can benefit from a myriad of lifestyle intervention programs like cardiac rehab.
However, the hesitation surrounding these programs is also patient driven. Often, patients will consider themselves beyond help or lack the knowledge on programs and lifestyles that can truly benefit them.
Addition, Taub mentioned that providers are often data driven, and since the medical community is lacking in data on frail and elderly populations, additional effort must be taken to properly inform and enroll patients in quality, life-enhancing programs.
Taub has had countless successes with cardiovascular programs with her patients.
In the interview, she spoke of 1 former patient with bilateral below-the-knee amputations who was skeptical of the benefits of cardiac rehabilitation. Taub convinced the patient to enroll in a strength training program, and in time both she and the patient recorded physical improvements.
“He did a lot of things that really improved his overall quality of life, there’s a lot of strength training that he did, there was a lot of resistance work that he did with bands, and by the end of the program, his skeletal muscle mass had increased his visceral fat had decreased his energy level and exercise performance had increased,” Taub said. “So, sometimes just educating patients that there are a lot of things we can offer.”