title: Multicenter Study of Temporal Trends in the Achievement of Atherosclerotic Cardiovascular Disease Risk Factor Goals During Cardiac Rehabilitation.
abstract: OBJECTIVE
  Secondary prevention risk factor goals have been established by the American Heart Association/American College of Cardiology, and the American Heart Association has further delineated ideal cardiovascular health metrics. We evaluated risk factor goal achievement during early-outpatient cardiac rehabilitation (CR) and temporal trends in risk factor control.
  
  
  METHODS
  Patients completed assessments on entry into and exit from CR at 35 centers between 2000 and 2009 and were categorized into 3 cohorts: entire (N = 12 984), 2000-2004 (n = 5468), and 2005-2009 (n = 7516) cohorts.
  
  
  RESULTS
  Improvements occurred in multiple risk factors during CR. For the entire cohort, the percentages of patients at goal at CR completion ranged from 95.5% for smoking to 21.9% for body mass index (BMI) of <25.0 kg/m. Compared with 2000-2004, the percentage of the 2005-2009 cohort at goal was higher (P < .001) for blood pressure, low-density lipoprotein cholesterol, and physical activity, lower (P = .005) for BMI, and not significantly different (P > .05) for fasting glucose and smoking. At CR completion, of those in the entire, 2000-2004, and 2005-2009 cohorts, 4.4%, 3.9%, and 4.8% (P = .219 vs 2000-2004), respectively, had all biomarkers at the goal for ideal cardiovascular health and, of those with atherosclerotic cardiovascular disease, 70.8%, 71.5%, and 70.3% (P = .165 vs 2000-2004), respectively, were receiving statins.
  
  
  CONCLUSIONS
  The percentage of patients at goal at CR completion increased for some, but not all, risk factors during 2005-2009 versus 2000-2004. Despite the benefits of CR, risk factor profiles are often suboptimal after CR. There remains room for improvement in risk factor management during CR and a need for continued intervention thereafter.
authors: INTERVENT International, LLC, Savannah, Georgia (Drs Gordon, Salmon, Wright, Mr Faircloth, and Ms Gordon); Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia (Dr Sperling); Cardiology and Interventional Vascular Associates, Dallas, Texas (Dr Berk); Division of Cardiovascular Medicine, University of Michigan, Ann Arbor (Dr Rubenfire); and Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, Michigan (Dr Franklin).
authors: Neil F
authors: NF
authors: Gordon
authors: Richard D
authors: RD
authors: Salmon
authors: Laurence S
authors: LS
authors: Sperling
authors: Brenda S
authors: BS
authors: Wright
authors: George C
authors: GC
authors: Faircloth
authors: Terri L
authors: TL
authors: Gordon
authors: Martin R
authors: MR
authors: Berk
authors: Melvyn
authors: M
authors: Rubenfire
authors: Barry A
authors: BA
authors: Franklin
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D000072038:Cardiac Rehabilitation / Q000379:methods*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D015444:Exercise; D005260:Female; D006040:Goals; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000517:prevention & control*; D012307:Risk Factors; D000074606:Smoking Prevention; D013995:Time
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol