[Changes of risk factors in patients with coronary heart disease after in-patient rehabilitation].
OBJECTIVE
Rehabilitation therapy of patients with coronary heart disease (CHD) aims at reducing cardiovascular risk factors and at maintaining reduced risk factor levels. The aim of this analysis was to assess to what degree current in-patient rehabilitation and subsequent out-patient care by general practitioners (GPs) achieve these goals.


METHODS
As part of the KAROLA-Study (Langzeiterfolge der KARdiOLogischen Anschlussheilbehandlung = Long-term success of cardiological rehabilitation therapy) 1206 patients between 30 and 70 years of age (mean age: male: 58.3 years, female: 60.8 years) who underwent in-patient rehabilitation due to CHD between January 1999 and May 2000 were recruited. Risk factor levels were assessed at the beginning and at the end of in-patient rehabilitation, and patients were re-examined one year after discharge using a standardised exam conducted by the GPs.


RESULTS
Patients with increased risk factor levels at the time of admission showed significant improvements in the following risk factors during rehabilitation: Body mass index (-0.7 kg/m(2)), diastolic blood pressure (-10 mmHg), systolic blood pressure (-10 mmHg), total cholesterol (-73 mg/dl), LDL-cholesterol (-63 mg/dl), HDL-cholesterol (+ 3 mg/dl), triglycerides (-70 mg/dl). One year after discharge, however, all but one of the parameters (LDL-cholesterol) had re-increased significantly. The prescription of lipid lowering drugs rose from 56 % to 76 % during rehabilitation therapy and remained constant during the first year after discharge.


CONCLUSIONS
During in-patient rehabilitation therapy important risk factors of CHD improved on average, but these improvements are only partly sustained in the long term. To ensure long-term success of rehabilitation measures more effective maintenance of risk factor modification in subsequent out-patient care is needed.
Küpper-Nybelen
J
J
Abteilung Epidemiologie, Deutsches Zentrum für Alternsforschung, Heidelberg.
Rothenbacher
D
D
Hahmann
H
H
Wüsten
B
B
Brenner
H
H
D000328:Adult; D000359:Aftercare; D000368:Aged; D000553:Ambulatory Care; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000209:etiology / Q000534:rehabilitation*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D000960:Hypolipidemic Agents; D014280:Triglycerides; D002784:Cholesterol