What To Expect During Cardiac Rehabilitation

During cardiac rehabilitation (rehab), you'll learn how to:

• Increase your physical activity and exercise safely
• Follow a heart healthy diet
• Reduce risk factors for future heart problems
• Improve your emotional health

The rehab team will work with you to create a plan that meets your needs. Each part of cardiac rehab will help lower your risk for future heart problems.

Over time, the lifestyle changes you make during rehab will become more routine. They will help you maintain a reduced risk for heart disease.

Support from your family can help make cardiac rehab easier. For example, family members can help you plan healthy meals and do physical activities. The healthy lifestyle changes you learn during cardiac rehab can benefit your entire family.

Increase Physical Activity and Exercise Safely

Physical activity is an important part of a healthy lifestyle. It can strengthen your heart muscle, reduce your risk for heart disease, and improve your muscle strength, flexibility, and endurance.

Your rehab team will assess your physical activity level to learn how active you are at home, at work, and during recreation. If your job includes heavy labor, the team may recreate your workplace conditions to help you practice in a safe setting.

You'll work with the team to find ways to safely add physical activity to your daily routine. For example, you may decide to park farther from building entrances, walk up two or more flights of stairs, or walk for 15 minutes during your lunch break.

Your rehab team also will work with you to create an easy-to-follow exercise plan. It will include time for a warmup, flexibility exercises, and cooling down. It also may include aerobic exercise and muscle-strengthening activities. You'll get a written plan that lists each exercise and explains how often and for how long you should do it.

You're more likely to make exercise a habit if you enjoy the activity. Work with the rehab team to find the types of activity that you enjoy and that are safe for you. If you prefer to exercise with other people, join a group or ask a friend to join you.

Exercise training as part of cardiac rehab may not be safe for all patients. For example, if you have very high blood pressure or severe heart disease, you may not be ready for exercise training. Or, you may only be able to tolerate very light conditioning exercises. The rehab team will help decide what level of exercise is safe for you.

Aerobic Exercise

Typically, your rehab team will ask you to do aerobic exercise 3 to 5 days per week for 30 to 60 minutes. The exercise specialist on your team will make sure that your exercise plan is safe and right for you.

Examples of aerobic exercise are walking (outside or on a treadmill), cycling, rowing, or climbing stairs.

Muscle-Strengthening Activities

Typically, your rehab team will ask you to do muscle-strengthening activities 2 or 3 days per week. Your exercise plan will show how many times to repeat each exercise.

Muscle-strengthening activities may include lifting weights (hand weights, free weights, or weight machines), using a wall pulley, or using elastic bands to stretch and condition your muscles.

Exercise at the Rehab Center and at Home

When you start cardiac rehab, you'll exercise at the rehab center. Members of your rehab team will carefully watch you to make sure you're exercising safely.

A team member will check your blood pressure several times during exercise training. You also may need an EKG (electrocardiogram) to check your heart's electrical activity during exercise. This test shows how fast your heart is beating and whether its rhythm is steady or irregular.

Your exercise program will change as your health improves. After awhile, you'll add at-home exercises to your plan.

Follow a Heart Healthy Diet

Your rehab team will help you create and follow a heart healthy diet. The diet will help you reach your rehab goals, which may include managing your weight, cholesterol levels, blood pressure, diabetes, kidney disease, heart failure, and/or other health problems that your diet can affect.

You'll learn how to plan meals that meet your calorie needs and are low in saturated and trans fats, cholesterol, and sodium (salt).

Your rehab team also may advise you to limit alcohol and other substances. Alcohol can raise your blood pressure and harm your liver, brain, and heart.

Reduce Risk Factors for Future Heart Problems

Your cardiac rehab team will work with you to control your risk factors for heart problems. Risk factors include high blood pressure, high blood cholesterol, overweight or obesity, diabetes, and smoking.

High Blood Pressure

High blood pressure raises your risk for future heart problems. The rehab team will work with you to reach the blood pressure goal your doctor sets. This goal will depend on factors such as your age and whether you have heart failure, diabetes, or kidney disease.

Exercising, losing weight, limiting how much salt and alcohol you consume, and quitting smoking can help you lower your blood pressure. You may need medicine to lower your blood pressure if lifestyle changes aren't enough.

For more information about lowering your blood pressure, visit the Diseases and Condition Index High Blood Pressure article and the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to Lowering High Blood Pressure."

High Blood Cholesterol

Too much cholesterol in the blood can cause heart disease. Your rehab team will work with you to lower high blood cholesterol. You can do this by following a heart healthy diet, losing weight, exercising, quitting smoking, and limiting how much alcohol you drink.

Physical activity also can increase HDL cholesterol, which is sometimes called "good" cholesterol. This is because it helps remove cholesterol from your arteries.

You may need medicine to lower your cholesterol if lifestyle changes aren't enough.

For more information about lowering your cholesterol, visit the Diseases and Condition Index High Blood Cholesterol article and the NHLBI's "Your Guide to Lowering Your Cholesterol With TLC."

Overweight and Obesity

If you're overweight or obese, your rehab team will help you set short- and long-term weight-loss goals. You can reach these goals by following the diet and exercise plans that the team creates for you.

For more information about losing weight or maintaining your weight, visit the Diseases and Condition Index Overweight and Obesity article and the NHLBI's Aim for a Healthy Weight Web site and "Aim for a Healthy Weight" patient booklet.

Diabetes

If you have diabetes, your rehab team will work with you to control your blood sugar level. Following a heart healthy diet, losing weight, and exercising can lower your blood sugar level.

Your doctor may suggest that you test your blood sugar before and after exercising to watch for numbers that are too high or too low. Your doctors will tell you what numbers to look for.

You may need medicine to lower your blood sugar level if lifestyle changes aren't enough.

For more information about diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases' Diabetes Overview.

Smoking

Smoking is a risk factor for heart disease. If you smoke, quitting can help you avoid future heart problems. Quitting can help lower your blood pressure and keep your cholesterol levels healthy.

Talk to your rehab team about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.

It may help to set a "quit date." Some people find it helpful to enroll in smoking cessation programs or to seek counseling. Other people find acupuncture or hypnosis helpful.

Improve Emotional Health

Psychological factors increase the risk of getting heart disease or making it worse. Depression, anxiety, and anger are common among people who have heart disease or have had a heart attack or heart surgery.

Get treatment if you feel sad, anxious, angry, or isolated. These feelings can affect your physical recovery. Depression is linked to complications such as irregular heartbeats, chest pain, a longer recovery time, the need to return to the hospital, and even an increased risk of death.

Seeking help is important. Group or individual counseling helps lower your risk for future heart attacks and death. It also may motivate you to exercise and help you relax and learn how to reduce stress.

People with heart disease who get mental health treatment often show improvements in blood pressure, cholesterol, and other measures of physical health.

The rehab team may include a mental health specialist, or someone from the team may be able to refer you to one. Without help from a professional, these problems may not go away.

Some communities have support groups for people who have had heart attacks or heart surgery. They also may have walking groups or exercise classes. Help with basic needs and transportation also may be available.

Counseling for Sexual Dysfunction

People who have heart problems sometimes have sexual problems. The most common problem is less interest or no interest in sex. Impotence or premature or delayed ejaculation may occur in men.

Depression, medicines, fear of causing a heart attack, or diabetes can contribute to sexual problems.

Sexual activity often is safe for low-risk patients. The maximum heart rate during usual sexual activity is similar to other daily activities, such as walking up one or two flights of stairs.

Talk to your doctor if you're having sexual problems or to find out whether sexual activity is safe for you.