Cardiovascular disorders are the leading cause of mortality and morbidity in the industrialized world. More than 14 million people suffer from some form of coronary artery disease (CAD) or its complications, which includes congestive heart failure (CHF), angina, or arrhythmias. Of this number, approximately 1 million survivors of acute Myocardial Infarction (MI), as well as the more than 300,000 patients who undergo coronary bypass surgery annually, are candidates for cardiac rehabilitation.
Cardiac rehabilitation programs help patients who have suffered the adverse pathophysiologic and psychological consequences of cardiac events. Currently, there are about 400,000 patients who undergo coronary angioplasty each year, making up another subgroup that could benefit from cardiac rehabilitation. An additional 4.7 million patients with CHF are also eligible for a slightly modified rehabilitation program, as are the ever-increasing number of patients who have undergone heart transplantation. Patients who are at low or moderate risk typically undergo early rehabilitation. Cardiac rehabilitation can:
- Improve quality of life
- Reduce the need for medicines to treat heart or chest pain
- Lower the risk for hospital readmission for a heart problem
- Prevent or reduce the risk of future heart problems
- Help an individual live a longer, healthier life
Rehabilitation involves adopting heart-healthy lifestyle changes to address risk factors for cardiovascular disease. These heart-healthy practices include exercise training, counseling to reduce stress and help patients return to a normal life, and patient education. The program is often provided in an outpatient clinic or in a hospital rehabilitation center by a cardiac rehabilitation team, which can include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and mental health specialists, depending on the individual’s specific needs.
During cardiac rehabilitation, patients learn to exercise safely and increase their physical activity levels. The goal of cardiac rehabilitation is to:
- Curtail the physical as well as the psychosocial effects of heart disease
- Relieve cardiac symptoms
- Reverse atherosclerosis, the build-up of fats and other substances in and on the artery walls
- Reintegrate heart disease patients into their families and communities successfully
- Limit the risk for reinfarction or sudden death
Among older patients, additional goals may include:
- Achievement of functional independence
- Prevention of premature disability
- Reduction in the need for custodial care
In observational studies, older patients have seen improvement in their exercise tolerance comparable to that of younger patients participating in similar exercise programs. Cardiac rehabilitation services are an effective and safe intervention, especially when they are developed by a professional care team and personalized to the patient. These services are undoubtedly an essential part of a successful recovery plan for patients with multiple presentations of coronary heart disease and heart failure.
A nutritionist may recommend a heart-healthy, well-balanced diet regimen. Fruits, vegetables and whole grains can help protect your heart and reduce your risk of heart disease. The DASH diet (Dietary Approaches to Stop Hypertension) and Mediterranean diet are among the top diets for heart and brain health. Generally, these diets promote low-fat proteins, such as beans, lean meats and fish, as well as low-fat or fat-free dairy products, fruits, and vegetables.
Below, we have curated a list of the top 8 heart-healthy foods based off recommendations from the DASH and Mediterranean diets. They include:
- Eat fish. Fish is high in omega-3 fatty acids, which may reduce inflammation, lower blood pressure, and decrease the risk for stroke and heart failure. Salmon, tuna, mackerel, herring, and trout contain the most omega-3 fatty acids and are most beneficial.
- Eat nuts. A handful of healthy nuts, such as almonds or walnuts, will keep you fuller for longer and are good for your heart, too. Nuts lower low-density lipoprotein (LDL), or “bad” cholesterol levels, which are known to play a major role in the development of plaque on blood vessels. Nuts also reduce inflammation linked to heart disease.
- Eat berries. Berries are packed with heart-healthy phytonutrients and soluble fiber. Try blueberries, strawberries, cranberries, or raspberries in cereal or yogurt.
- Add flaxseeds to a smoothie. Flaxseeds contain omega-3 fatty acids, fiber, and phytoestrogens to boost heart health. Take them in ground or milled form to reap the greatest benefit.
- Eat beans. Dark beans, such as kidney or black beans, are high in fiber, B-vitamins, minerals, protein, and more. Like nuts, the fiber in beans lowers bad cholesterol levels, reducing the risk of heart disease.
- Drink red wine. A 4-ounce glass of red wine can improve good (HDL) cholesterol levels. Drinks should be limited to one per day for women and up to two per day for men.
- Eat yellow, orange, and red fruits and vegetables. Colorful vegetables, such as carrots, sweet potatoes, red peppers, and acorn squash, are packed with carotenoids, fiber, and vitamins. Carotenoids act as antioxidants and tackle harmful free radicals that damage tissues in the body, among other health benefits.
- Eat chocolate. Dark chocolate, that is! Dark chocolate is over 65% polyphenol-rich cocoa and lowers blood pressure when enjoyed in moderation.
Dietary guidelines can be strict, and it can be difficult to stay committed. Try incorporating two of the above tips to fuel your heart and body with a variety of nutritious foods, and follow more rules over time.
Along with the above mentioned tips, a heart-healthy diet also limits the intake of sodium, saturated and trans fat, added sugars, and alcohol. We put together 3 heart-healthy recipes for you to enjoy.
Honey-Glazed Roasted Delicata Squash
Tangy cider vinegar, sweet honey, crunchy pine nuts, and fresh mint come together to make an amazing glaze in this healthy, roasted winter squash recipe. If you use delicata, the whole squash—including the gorgeous skin—is edible.
Ingredients
- 5 pounds delicata or acorn squash
- 4 shallots, quartered lengthwise
- 3 tablespoons extra-virgin olive oil
- 1/2 teaspoon fine sea salt plus a pinch, divided
- 1/4 teaspoon ground pepper
- 1/2 cup honey
- 1/2 cup cider vinegar
- 1/2 cup pomegranate seeds
- 1/4 cup pine nuts, toasted
- 1/4 cup fresh mint, finely chopped
Directions
- Place racks in upper and lower thirds of oven. Preheat to 400°F.
- Cut the squash in half lengthwise, and scoop out the seeds. Then cut the squash crosswise into 1-inch-thick slices.
- In a large mixing bowl, toss the slices of squash with shallots, oil, 1/2 teaspoon salt, and pepper. Divide between 2 large rimmed baking sheets.
- Roast the squash for about 30 to 40 minutes, turning each piece over and rotating the pans top to bottom halfway through. The squash should be tender and caramelized in spots. Transfer the squash and shallots to a serving platter.
- Right before serving, mix the honey, vinegar, and a pinch of salt in a small saucepan and bring to a boil over high heat. Reduce heat to a lively simmer and cook 5 to 8 minutes until it has been reduced to about 1/2 cup. Immediately drizzle the syrup over the squash.
- Serve topped with pomegranate seeds, pine nuts and mint. Enjoy!
Moist, Cocoa-Enriched Brownie Bites
Cocoa nibs are broken bits of husked cocoa beans that add delicate chocolate flavor and a delicious nutty crunch to baked goods. They can be found at upscale supermarkets and gourmet cookware stores. As you prepare this recipe, don’t be alarmed that the batter is very wet—the end result will be moist, tender mini-cakes that will leave everyone’s mouth watering.
Ingredients
- 1/2 cup self-rising flour
- 2/3 cup sugar
- 3 tablespoons unsweetened cocoa
- 4 large egg whites
- 2 tablespoons canola oil
- 3 tablespoons chocolate liqueur (optional)
- 1/3 cup cocoa nibs
- Cooking spray
- Roasted, salted almonds (such as Blue Diamond), coarsely chopped (optional)
- Powdered sugar (optional)
Directions
- Preheat oven to 400°F.
- Combine flour, sugar, and cocoa in a medium bowl, and whisk the mixture.
- In a separate bowl, whisk the egg whites until foamy. Add oil and liqueur, if desired, and continue stirring.
- Add egg white mixture to flour mixture, stirring until just moistened. Fold in cocoa nibs. Spoon batter evenly into 24 miniature muffin cups coated with cooking spray. If desired, sprinkle batter evenly with almonds.
- Bake for 8 minutes. Remove brownie bites from pans, and cool on wire racks. Sprinkle with powdered sugar, and serve!
Peanut Butter Pie Recipe
This pie recipe is great for those looking to lead a heart-healthy lifestyle. It cuts down on saturated fat by using fat-free dairy products and is also low in cholesterol. On top of that, it’s tasty and easy to make!
Yields 10 servings
Ingredients
- 1 2/3 cups chocolate graham cracker crumbs (about 8 1/2 cookie sheets)
- 7 tablespoons sugar (separated into 3 tablespoons and 4 tablespoons)
- 2 large egg whites, lightly beaten
- Cooking spray
- 1 1/4 cups fat-free milk
- 2/3 cup reduced-fat crunchy peanut butter
- 1/2 teaspoon vanilla
- 1/2 cup (4 ounces) fat-free cream cheese, softened
- 1 (8-ounce) container of frozen, fat-free whipped topping, thawed
- 3 tablespoons finely chopped, salted, dry-roasted peanuts
- 1/4 cup shaved dark chocolate (about 1 ounce)
Preparation
- Preheat oven to 350°.
- Combine the graham cracker crumbs, 3 tablespoons sugar, and egg whites in a medium-sized bowl; toss with a fork until moist.
- Lightly coat hands with cooking spray. Coat 9-inch deep-dish pie plate with cooking spray, and press mixture into bottom and up sides. Prick crust with a fork before baking.
- Bake at 350° for 10 minutes. Remove from oven; cool on a wire rack.
- Combine milk and remaining sugar in a heavy saucepan over medium-low heat. Cook 2 minutes or until sugar dissolves, stirring constantly; transfer mixture to a bowl. Add peanut butter and vanilla, stirring with a whisk until combined. Cover and chill 30 minutes.
- Place cream cheese in a large bowl, and beat with a mixer at medium speed until light and fluffy.
- Add milk mixture to cream cheese mixture, beating on low speed until combined. Fold in whipped topping, and pour mixture into prepared piecrust.
- Freeze, uncovered, 8 hours (or overnight); pie should be hard. Sprinkle with peanuts and shaved chocolate. Transfer pie to refrigerator 30 minutes before slicing to slightly soften it. Enjoy!
If your loved one is living with heart health issues, a private duty nurse can help. Our nurses can administer medications, perform weekly check-ins, and generally ensure the overall comfort of a patient. If you’re interested in learning more about what NurseRegistry can do for you, call us at (650) 462-1001.
Sources
Anderson, C.D. Adams, E.M. Antman et al, “ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines,” J Am Coll Cardiol, 50 (2007), pp. e1–e157.
Balady GJ., et al., “Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical centers and beyond: a presidential advisory from the American Heart Association,” Circulation, 2011; 124:2951-2960.
“Cardiac Rehabilitation,” National Heart, Lung, and Blood Institute, National Institutes of Health, December 9, 2016
Dunlay SM et al., “Barriers to participation in cardiac rehabilitation,” Am Heart J. 2009 November; 158(5): 852–859
LD Hillis, PK Smith, JL Anderson et al, “2011 ACCF/AHA guideline for coronary artery bypass graft surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines,” J Am Coll Cardiol, 124(2011), pp.123210.
Singh, V., “Cardiac Rehabilitation,” Medscape, August 12, 2015.
“Nuts and your heart: Eating nuts for heart health”, Mayo Clinic.
“Phytonutrients”, WebMD.
“Dark Chocolate Can Be Part of a Heart-Healthy Diet”, Dr. Sinatra.
