Take Care of Your Heart Before and After Problems

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"The lifetime risk for developing heart failure in both men and women is one in five," said Fonarow. "However, heart failure can be prevented, and there are a number of modifiable risk factors for heart failure, including hypertension, obesity, and diabetes.

"Maintaining a healthy blood pressure and body weight is essential to reduce the risk of heart failure," he said.

The second study found that fewer than 20 percent of patients seek cardiac rehabilitation after a heart attack or coronary bypass surgery.

"It has been shown by many trials that cardiac rehabilitation reduced the risk for new coronary events, re-hospitalization and mortality. The main advantage of cardiac rehabilitation is to reduce mortality," said study leader Dr. Jose A. Suaya, a lecturer and scientist at the Brandeis University Schneider Institutes for Health Policy, Heller School, in Waltham, Mass.

Cardiac rehabilitation also improves functional capacity, Suaya said. "Patients can walk more without pain and improve their quality of life," he said.

For the study, Suaya's group collected data on 267,427 men and women, 65 and older, who had survived a heart attack or bypass surgery. The data were drawn from 1997 Medicare claims records.

In the year after hospital discharge, only 18.7 percent of the patients had at least one session of cardiac rehabilitation. Patients who underwent bypass surgery were more likely to seek rehabilitation -- 31 percent -- compared with heart attack patients -- 13.9 percent.

More men had cardiac rehabilitation (22.1 percent) than women (14.3 percent). Age also played a role -- patients 75 to 85 were less likely to go for rehabilitation, the researchers found.

In addition, patients with other medical conditions, such as diabetes, a previous stroke, congestive heart failure or cancer, were significantly less likely to seek cardiac rehabilitation, Suaya's group found.

The study results are published in the Oct. 9 issue of the journal Circulation.

There are many reasons why patients don't seek rehabilitation, the researchers said.