Cardiac rehabilitation for workers with ischemic heart disease Benefits for cardiovascular health and quality of life

Abstract

Cardiac rehabilitation programs (CRPs) are multifactorial interventions defined by the World Health Organization as essential strategies to improve patients’ health-related quality of life (HRQoL) by enhancing their physical, psychological, social, and occupational well-being. These programs are a cornerstone in the comprehensive treatment of heart disease, facilitating the recovery of functional capacity and reintegration into the workforce through a multidisciplinary approach. The objective of this study was to assess the efficacy of CRPs in enhancing functional capacity (cardiac and psychological) and HRQoL in workers with ischemic heart disease. An observational pre-post study without a control group was conducted, focusing on actively employed individuals with ischemic heart disease. A total of 214 patients were included, selected according to specific inclusion criteria after excluding those not suitable for longitudinal follow-up. Participants were active workers aged 18 to 65 years who were prescribed a CRP between January 2020 and December 2021. Sociodemographic, occupational, cardiovascular risk, and clinical-therapeutic data were collected to evaluate changes following completion of the program. Health-related quality of life (HRQoL) was also assessed. A total of 214 patients were included, 83.9% male, with a mean age of 54.21 years. Most had a history of hypertension, dyslipidemia, smoking, low physical activity, overweight or obesity, and a family history of ischemic heart disease. Among those who started the program (94.4%), the most common diagnosis was acute myocardial infarction involving a single coronary vessel. Additionally, 77.1% underwent stent angioplasty, and 47.2% participated in a moderate-risk CRP. After completion, the SF-36 score improved significantly (46.92 vs 70.21), and depressive symptoms decreased (55.10% vs 38.22%). Significant benefits were observed in most modifiable cardiovascular risk factors, along with an increase in the proportion of patients with preserved left ventricular ejection fraction (65.4% vs 72%) and in metabolic equivalent (MET) levels. In 157 participants (73.4%), MET gain was quantified, with a mean increase of 2.67 ± 1.64 METs. These findings suggest that cardiac rehabilitation, as a secondary prevention strategy, effectively improves cardiac function and HRQoL in working-age patients with ischemic heart disease.