Reset your heart health

Heart disease can take decades to develop, with years of poor lifestyle habits contributing to the problem. By the time damage shows up, it may seem like there’s no way to reverse it. But a number of programs — typically offered in group sessions, in an outpatient hospital or community setting — can help you change unhealthy habits, reduce heart attack risk, and boost your longevity. Here’s a look at some of the available programs.

Cardiac rehabilitation

Cardiac rehabilitation (“rehab”) is a medically supervised three-month program for people who’ve had a heart attack, heart bypass surgery, a heart or a heart and lung transplant, stenting to open arteries, or valve surgery, as well as those with chronic chest pain (angina) or certain kinds of heart failure.

A team of doctors and other experts assess participants’ health needs and develop individualized treatment programs that focus on exercise, a heart-healthy diet, weight control, stress reduction, sleep, and medication adherence. Groups meet for education and training several times per week, for three months. “We give you the tools to make lasting change. For instance, we work with you to overcome barriers, such as how to cope with arthritis that’s keeping you from exercising,” explains Dr. Romit Bhattacharya, a preventive cardiologist at Harvard-affiliated Massachusetts General Hospital (MGH).

Experts also guide participants’ progress and monitor their exercise sessions. “You have an exercise physiologist there with you, so you learn what it feels like when you’re safely pushing the limits and when you should pull back. That helps address the fear element about whether you’re overdoing it,” Dr. Bhattacharya says.

It adds up to proven benefits. Evidence suggests that people who attend cardiac rehab reduce their risk of heart attack by 31% and that people who complete all 36 sessions (typically in three months) reduce their risk of death by 47% compared with those who only complete one session. Cardiac rehab also improves overall physical function and reduces chest pain.

Cardiovascular wellness programs

Cardiovascular wellness programs are for people who don’t qualify for cardiac rehab but want to improve their heart and blood vessel health. They’re offered at hospitals, academic centers, private doctor practices, fitness centers, and even community centers.

Programs vary greatly in their approaches, expertise, topics, and length. Some are similar to cardiac rehab, with a team of health professionals who provide months of health monitoring and training. An example of that is MGH’s Cardiac Lifestyle Program. It’s for people who have an abnormal heart rhythm, certain kinds of heart failure, obesity, diabetes, or at least one heart disease risk factor (such as elevated weight, blood sugar, cholesterol, or blood pressure).

Other programs are open to anyone and have just one or two experts who focus on a few areas of health. These programs may last for a couple of weeks or even just one session.

Who pays for these programs?

Costs vary by program and provider. For people with qualifying conditions, insurance (including Medicare) covers the costs of cardiac rehab and a similarly classified program called the Ornish Reversal Program, offered at certified hospitals and clinics across the country. Depending on the provider, the Ornish program is also open to anyone who wants to improve cardiovascular health and is willing to pay for it out of pocket (for about $7,000 to $10,000).

Other programs, such as MGH’s Cardiac Lifestyle Program, are partially covered by insurance. And some others are free or have a minimal charge.

Make sure the program is clear with you about what services it offers, how much it costs, how many experts are involved, and how often and where your group will meet.

Program barriers

Despite the benefits of these programs, many people don’t use them. “By some estimates, only 10% to 34% of people who qualify participate in cardiac rehab,” Dr. Bhattacharya says. “It’s often because of the diagnosis. For instance, only 10% of patients with heart failure are referred to the program, and less than 3% attend. Prevention is something that doesn’t get as much of a spotlight as it should.”

Other barriers to these programs include transportation issues, fear of being too unfit to take part, and unconscious bias in referrals. “Women and minorities, and people with limited English language skills, are less likely to be referred or participate,” Dr. Bhattacharya says. He stresses that we need to change this thinking. “These programs are not yet ‘democratized’ and made available to as many people as they should,” Dr. Bhattacharya notes. “But it could be that everyone would benefit from a group-based program to live the healthiest life they can.”

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Suppose you find fifty righteous people living there in the city—will you still sweep it away and not spare it for their sakes? (Genesis 18:24) And the Lord replied, “If I find fifty righteous people in Sodom, I will spare the entire city for their sake.” (Genesis 18:26)

And be sure to say, ‘Look, your servant Jacob is right behind us.’” Jacob thought, “I will try to appease him by sending gifts ahead of me. When I see him in person, perhaps he will be friendly to me.” (Genesis 32:20)
to say to you: ‘Please forgive your brothers for the great wrong they did to you—for their sin in treating you so cruelly.’ So we, the servants of the God of your father, beg you to forgive our sin.” When Joseph received the message, he broke down and wept. (Genesis 50:17)

“Forgive my sin, just this once, and plead with the Lord your God to take away this death from me.” (Exodus 10:17)
Pay close attention to him, and obey his instructions. Do not rebel against him, for he is my representative, and he will not forgive your rebellion. (Exodus 23:21)

Moses Intercedes for Israel The next day Moses said to the people, “You have committed a terrible sin, but I will go back up to the Lord on the mountain. Perhaps I will be able to obtain forgiveness for your sin.” (Exodus 32:30) So Moses returned to the Lord and said, “Oh, what a terrible sin these people have committed. They have made gods of gold for themselves. (Exodus 32:31) But now, if you will only forgive their sin—but if not, erase my name from the record you have written!” (Exodus 32:32)

The Lord passed in front of Moses, calling out, “Yahweh! The Lord! The God of compassion and mercy! I am slow to anger and filled with unfailing love and faithfulness. (Exodus 34:6) I lavish unfailing love to a thousand generations. I forgive iniquity, rebellion, and sin. But I do not excuse the guilty. I lay the sins of the parents upon their children and grandchildren; the entire family is affected— even children in the third and fourth generations.” (Exodus 34:7)

And he said, “O Lord, if it is true that I have found favor with you, then please travel with us. Yes, this is a stubborn and rebellious people, but please forgive our iniquity and our sins. Claim us as your own special possession.” (Exodus 34:9)
just as he does with the bull offered as a sin offering for the high priest. Through this process, the priest will purify the people, making them right with the Lord, and they will be forgiven. (Leviticus 4:20) Then he must burn all the goat’s fat on the altar, just as he does with the peace offering. Through this process, the priest will purify the leader from his sin, making him right with the Lord, and he will be forgiven. (Leviticus 4:26)

Then he must remove all the goat’s fat, just as he does with the fat of the peace offering. He will burn the fat on the altar, and it will be a pleasing aroma to the Lord. Through this process, the priest will purify the people, making them right with the Lord, and they will be forgiven. (Leviticus 4:31) Then he must remove all the sheep’s fat, just as he does with the fat of a sheep presented as a peace offering. He will burn the fat on the altar on top of the special gifts presented to the Lord. Through this process, the priest will purify the people from their sin, making them right with the Lord, and they will be forgiven. (Leviticus 4:35)

The priest will then prepare the second bird as a burnt offering, following all the procedures that have been prescribed. Through this process the priest will purify you from your sin, making you right with the Lord, and you will be forgiven. (Leviticus 5:10) Through this process, the priest will purify those who are guilty of any of these sins, making them right with the Lord, and they will be forgiven. The rest of the flour will belong to the priest, just as with the grain offering.” (Leviticus 5:13)

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