Clinician checking heart of older man

Veterans who participated in home-based cardiac rehabilitation (HBCR) programs following a heart attack or cardiac procedure had lower mortality rates than those who turned down the treatment, according to a study published in the Journal of the American Heart Association.

The study included 1,120 patients with ischemic heart disease at the San Francisco Veterans Health Administration who were offered HBCR between 2013 and 2018. Of that cohort, 490 opted for home-based care. During a follow-up a little more than four years later, one-fifth of the patients who declined home-based rehab died, however, those who opted for rehab at home had a 36% lower mortality rate. 

The veterans were mostly men with an average age of 68. The program included up to nine coaching calls, motivational interviews, a workbook and personal health journal to help the patients log vital signs, exercise and diet. The participants received blood pressure monitors, scales and stationary bikes. They also worked one-on-one with a nurse or exercise pathologist. Follow-up calls were made to the veterans at three and six months. 

While the patients who participated in home-base care also had lower hospitalization rates, researchers admitted participation and adherence to the program required significant motivation on the part of the veterans. Still, the researchers said HBCR could be a gamechanger in the survival rate of some patients.

“Access to a HBCR program becomes critical in bridging the gap in access to CR and improving survival after hospitalization for serious cardiovascular illness,” the researchers stated in the report. “We hope that the pragmatic evidence from our study will encourage the development of more HBCR programs to help address this gap. 

The American Heart Association defines cardiac rehabilitation as a medically supervised program that includes exercise counseling and training, education for heart-healthy living and counseling to reduce stress.