Treating the "heart" of the elderly: Remember the "five prescriptions" for cardiac rehabilitation

The "China Cardiovascular Health and Disease Report 2021" shows that the incidence and mortality rates of cardiovascular diseases in China are both at the top. my country is facing the dual crises of an aging population and metabolic risk factors (hypertension, diabetes, hyperlipidemia, obesity), and the burden of cardiovascular diseases in the elderly continues to rise. At present, the level of diagnosis and treatment technology for cardiovascular diseases in my country has made great progress. Through technical means such as percutaneous coronary intervention, the time for vascular recanalization of myocardial ischemic events has been significantly shortened, but the mortality and recurrence rates of cardiovascular diseases have not decreased. Studies have shown that cardiac rehabilitation can enhance the cardiopulmonary function of the elderly, increase exercise tolerance, reduce negative emotions such as anxiety and depression, improve the quality of life, and significantly reduce the mortality rate of cardiovascular diseases.

What is Cardiac Rehabilitation?

Cardiac rehabilitation is based on overall medical assessment. Through five core prescriptions, various risk factors are controlled, unhealthy lifestyles are changed, and comprehensive and full-course management services and care are provided to cardiovascular disease patients in the acute phase, recovery phase, maintenance phase, and throughout the life cycle in terms of physiology, psychology, and society. The elderly are the main population for cardiac rehabilitation, and the rational use of cardiac rehabilitation can promote the recovery of elderly patients as soon as possible.

Five core prescriptions:

1. Drug prescription

Drug prescription is the basis of cardiac rehabilitation, and reasonable, standardized and safe individualized medication is crucial for the elderly.

(II) Exercise prescription

Exercise prescription is the core of cardiac rehabilitation. Exercise can improve metabolic risk factors for cardiovascular disease, thereby improving the physical fitness of the elderly, reducing the risk of falls, improving independent living ability, and promoting mental health.

What are the types of exercise?

1. Aerobic exercise: such as walking, jogging, swimming, etc. The exercise time is 20-40 minutes each time, and the exercise frequency is 3-5 times a week. Low and moderate intensity is appropriate for the elderly. Aerobic exercise can increase blood perfusion, reduce blood viscosity, and prevent the occurrence of cardiovascular and cerebrovascular diseases.

2. Resistance exercise: including push-ups, stretching elastic bands, lifting dumbbells, etc., exercise frequency is 2-3 times a week. Resistance training can improve muscle strength and exercise endurance of elderly patients with cardiovascular diseases, improve bone density, etc.

3. Flexibility training: can reduce muscle stiffness in the elderly, improve joint flexibility and reduce the risk of injury.

4. Balance and coordination exercise training: can improve the elderly’s ability to maintain body posture and control movement, reducing the risk of falling.

3. Nutritional prescription

The elderly are prone to malnutrition due to multiple factors such as aging and disease, and malnutrition is closely related to the morbidity and mortality of cardiovascular diseases. Providing healthy dietary guidance for the elderly and using individualized nutritional prescriptions can significantly improve their nutritional status.

4. Psychological Prescription

Elderly patients with cardiovascular diseases often have varying degrees of anxiety, depression and other negative emotions, which lead to an increase in cardiovascular events. Supportive psychological help (listening, companionship, acceptance), drug intervention, exercise therapy and sleep management are all important contents of psychological prescriptions. Reasonable use can improve anxiety and depression and reduce all-cause mortality of cardiovascular diseases.

5. Prescription for smoking cessation

Smoking is an independent risk factor for cardiovascular disease and has adverse effects on coronary arteries and peripheral blood circulation. Quitting smoking can reduce the risk of cardiovascular disease and death.