Introduction: Cardiac rehabilitation (CR) programming is highly dependent upon clinical and demographic characteristics of CR participants. We describe the evolution of these characteristics at entry into our phase II CR program over 10 years.
Methods: We reviewed data prospectively collected from 1996 to 2006. Based on the period of patient recruitment, we created 5 approximately equal groups: period 1 (1996-98) (N = 604), period 2 (1999-2000) (N = 571), period 3 (2001-2002) (N = 590), period 4 (2003-2004) (N = 520), and period 5 (2005-2006) (N = 532).
Results: From period 1 to 5, age increased from 60.6 (+/-11.4) to 63.4 (+/-11.1) years (P < .01), while the proportion of women, which was 25% initially, did not change. Weight increased from 84.7 (+/-18.3) to 88.5 (+/-19.0) kg (P < .01) and waist circumference increased from 101(+/-14) to 104 cm (+/-15) (P = .01), both driven mostly by an increase in men. Low-density lipoprotein (LDL) cholesterol (C) significantly decreased (118+/-35 to 86+/-33 mg/dL, P < .01), as did total C and triglycerides, while HDL C increased significantly (38 +/-10 to 42 +/-12 mg/dL, P < .01). The proportion of patients on statins increased from 25 to 77% (P < .01), although more men (80%) than women (70%) were taking a statin during the last period (P = .01). There was an increase in the proportion of patients with diabetes mellitus (DM) (17% to 25%, P < .01) and hypertension (HTN) (48% to 71%, P < .01) but not in the prevalence of smoking, which was initially low (7%). Relative peak Vo2 decreased significantly (20 +/-7 to 18 +/-6 mL O2 kg-1 min-1, P < .01) as did absolute peak Vo2.
Conclusion: Cardiac risk profile evolved significantly over 10 years in patients referred to CR. Participants are now older, more overweight, more likely to have DM, and HTN, and they are less fit. However, their lipid profile greatly improved, likely the result of a 3-fold increase in statin use. CR continues to be underutilized by women. These observations shed new light on contemporary challenges in CR.