Despite significant advances in the prevention and treatment of coronary artery disease over the past decade, there has not been a corresponding decrease in the prevalence of cardiovascular risk factors. Obesity is a growing epidemic and cigarette use continues to increase, especially in developing countries. As a practicing cardiologist in the metropolitan New York area, I often note how relatively easy it is to help patients achieve target lipid, blood pressure, and diabetic control with the medications available today. Despite excellent local resources to help patients with smoking cessation and weight management, reducing these risk factors is an uphill battle, often not won.
Clearly, as a society we have a major challenge, not only to understand human behavior but also to work with government and industry to provide and foster healthy choices, especially for children and youth.This edition of US Cardiovascular Disease 2006 reflects the complex nature of cardiovascular disease, including the challenges inherent in primary and secondary prevention.
The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) also recognizes these challenges and continues to partner with other professional organizations to increase access to effective secondary prevention programs for appropriate patients. Recently, the Centers for Medicare and Medicaid Services (CMS) released an updated coverage policy for cardiac rehabilitation that expanded the diagnoses covered to include post percutanueous transluminal coronary angioplasty (PTCA)/stent, valve surgery, and heart or heart/lung transplantation as well as stable angina, post-myocardial infarction and coronary artery bypass graft (CABG).The policy also recognizes that cardiac rehabilitation "is a comprehensive, long-term program including medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling." It is clear that secondary prevention is most effective when the treating physicians, patient, and rehabilitation staff work together to individualize a plan that can be sustained in the long term.
AACVPR has been working to help members more effectively integrate cardiac rehabilitation into their communities, in order to facilitate care coordination with treating physicians and promote life-long adherence with medications and lifestyle change. Frequent patient-staff contacts during cardiac rehabilitation reinforce lifetime strategies and empower patients to improve modifiable risk factors. Additionally, experience and training position cardiac rehabilitation staff as ideal resources for other prevention and treatment programs, such as peripheral arterial disease, obesity, and diabetes.
US Cardiovascular Disease 2006 is a unique communication tool for non-profit organizations and industry to learn about advances in cardiovascular prevention and treatment and to explore opportunities for collaboration. AACVPR is proud to introduce this edition of US Cardiovascular Disease 2006 and looks forward to continuing and developing partnerships that foster our mission – "to reduce morbidity, mortality, and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research, and aggressive disease management".