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Tuesday, May 19, 2009

"Walk often and walk far"

A new study in Circulation proposes a new approach to Cardiac Rehabilitation.

I often refer patients to cardiac rehab. Medicare pays for cardiac rehab for 5 distinct patient diagnoses: after bypass, after valve surgery, after heart attack, after percutanous intervention (angioplasty/stenting), chronic stable angina and after heart transplant.

There are multiple proven benefits of cardiac rehab. In all though, patients who participate in cardiac rehab have a roughly 30% reduction in major cardiovascular events (heart attack, cardiac death, stroke).  This is huge and compares very favorably to the best medicines I can prescribe to reduce risk.

In a typical cardiac rehab program, patients burn roughly 800 kcal per week, typically 3 days a week.

In this new program, patients walked at a moderate pace for 45-60 minutes per day, 5-6 days a week.

In the new program, patients lost much more weight and had marked reductions in insulin resistance. 

This study reinforces what I have been telling my patients for years. "Get off your butt and be active." The more you can do, the better -- 1 hour is better than 45 minutes, 45 minutes is better than 30 minutes. There is no better way to lose weight and be healthy than by being active and getting lots of exercise

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