By Patrick Savage, MS
As one year draws to an end and another begins, some of us participate in the ritual of resolving to change something that we view as a less than desirable trait or behavior, strive to achieve a specific goal or otherwise improve our quality of life. In a few important ways, there are significant parallels between the rituals associated with New Year’s resolutions and the goals made in cardiac rehabilitation.
The start of a new year is a logical, although a bit arbitrary, marker in time to commit to a positive change. Traditionally, flipping the page on the calendar, at least psychologically, represents an opportunity to “wipe the slate clean” and start fresh. There are other milestones or impactful events, however, that might move us to action. Clearly, experiencing a significant cardiac event represents another occasion for us to take stock of our health and to endeavor to make the necessary changes required to better our health and improve our quality of life. A critical step on the road to recovery for individuals that experience a cardiac event is to enroll in cardiac rehabilitation.
YouGov statistics from 2020 reveal that only about 27% of Americans make a New Year’s resolution. This is remarkably similar to the percentage of eligible individuals that participate in cardiac rehabilitation, according to research published that same year in Circulation: Cardiovascular Quality and Outcomes. Most of us have at least one (and some of us have many more than one) behavior that we should resolve to change and, yet, we do not. Similarly, most of the over 70% who do not participate in cardiac rehabilitation would benefit if they did, Richey et al reported in their journal paper.
Moreover, there is evidence that fewer than 50% of people who make a New Year’s resolution are successful in keeping it. That, too, is remarkably similar to the percentage of individuals who enroll in and complete cardiac rehabilitation. Only about half of the people that start cardiac rehabilitation end up completing the program. Clearly, these percentages are unacceptable. These staggering numbers, however, provide evidence of what we all know; making a commitment to behavior change and following it through to fruition is very difficult. Cardiac rehabilitation professionals must resolve to do a better job ensuring that patients are referred to, enroll in and complete cardiac rehabilitation.
Another connection between New Year’s goals and cardiac rehabilitation are the resolutions themselves. We are all familiar with the most common objectives—many are the same priorities of cardiac rehabilitation programming. For example, quitting smoking, exercising regularly, losing weight, eating right and reducing stress are typical New Year’s resolutions; and all are essential components of secondary prevention and are incorporated into cardiac rehabilitation programming. All of these examples of self-improvement necessitate behavior change, which explains why the resolutions are so difficult to achieve. In contrast to trying to take on a New Year’s resolution on our own, cardiac rehabilitation provides the structure and support to assist people as they strive to achieve meaningful and lasting behavior change.
Just as the song Auld Lang Syne is inextricably linked to New Year’s Eve, cardiac rehabilitation should be similarly associative for individuals recovering from a cardiac event. As one year ends and another begins, we take stock of where we are now and embrace the possibilities of what is to come. However, whereas the song reflects upon memories of past times, cardiac rehabilitation is all about looking forward to the future. Cardiac rehabilitation provides patients with the opportunity to bid farewell to past behaviors and set a goal of health and happiness in the future. To turn a phrase from the song, “Should auld unhealthy behaviors be forgot And never brought to mind?” The answer, of course, is yes.
Whether it is January or June, all patients recovering from a cardiac event who are eligible and appropriate should be referred to cardiac rehabilitation. As cardiac rehabilitation professionals, our New Year’s resolutions should include developing programming that will support our patients’ goals to modify their lifestyle to achieve long-term favorable health outcomes.
Wishing health and happiness to all, both patients and cardiac rehabilitation professionals, in 2022.
Patrick Savage, an AACVPR Fellow and a JCRP Associate Editor, is Clinical Lead and Senior Exercise Physiologist in the Cardiac Rehabilitation Program, Division of Cardiology, at the University of Vermont Medical Center.