Studies show only 1 cardiac rehab spot exists for every 12 heart attack victims

TORONTO, July 4, 2019听鈥撀燤ore than 20 million people develop heart disease globally each year, but there is only one cardiac rehab spot for every 12 of those patients to prevent another heart event, according to new research from 91亚色. A global audit and survey of cardiac rehab conducted in 91亚色鈥檚 Faculty of Health showed that cardiac rehab is available in only half of the world鈥檚 countries, and the programs that do exist can only serve 1.65 million patients, leaving a gap of over 18 million patients in need.

This first-ever audit and survey was undertaken through the International Council of Cardiovascular Prevention and Rehabilitation. Heart disease is a chronic condition; 聽cardiac rehabilitation provides heart attack patients structured exercise, risk factor management, as well as education and counselling to optimize their quality of life. Previous research has shown cardiac rehab reduces cardiovascular death and re-hospitalization by 20 percent.

Two papers reporting on the and were published in the journal EClinicalMedicine of the Lancet family today, quantifying how much rehab capacity exists in relation to need in every country, and the quality of programs in countries where it exists. professor in the Faculty of Health at 91亚色 was the senior investigator on the studies, with lead authors Turk-Adawi of Qatar University and Marta Supervia of Gregorio Mara帽贸n General University Hospital.

鈥淎lmost half of countries around the globe have absolutely no cardiac rehab,鈥� said Grace. 鈥淧eople are dying unnecessarily without these programs.鈥�

The goal of the first study was to establish availability of cardiac rehab and capacity to serve patients globally. The global team of 58 investigators established that cardiac rehab programs were available in 55 percent of the approximately 200 countries in the world. Researchers then surveyed all of the almost 6,000 programs and got responses from 93 of the 111 countries with rehab. Programs reported treating fewer than expected patients every year, due primarily to lack of resources.

from this study shows that while Canada ranks among the best in the world for program capacity, cardiac rehab is only available in the provinces, with no programs in the Territories. Overall, there is only one cardiac rehab spot for every 4.5 heart attack patients each year nationally. While Ontario has the most programs, the unmet need for cardiac rehab is greatest there.

Africa and South-East Asia are the regions in the greatest need for more programs. India, China and Russia were the countries in greatest need; each needs millions more rehab spots to treat the average number of patients that develop heart disease each year currently, and unfortunately, that number is expected to grow.

The second study presented the results of the first-ever survey of the cardiac rehab programs worldwide that exist, to find out the nature of services delivered, such as types of patients served, number and types of healthcare professionals on the rehab teams, and services delivered. This study found cardiac rehab programs are of high quality where they are available, and often treat patients with chronic conditions other than heart disease.

The results showed that the existing programs generally met international standards, offering an average of nine out of the 11 recommended core components, but this varied by region. There was inconsistent delivery of interventions for tobacco cessation, managing stress and supporting return-to-work; the situation is the same in Canada. Programs were staffed by an average of 6 staff to deliver these components, generally comprising exercise professionals, nurses, dietitians and physicians.

Researchers say advocacy is needed for more programs that are reimbursed by public healthcare systems or private healthcare insurance. 鈥淚ncreased capacity could be also be achieved by delivering more unsupervised programs 鈥� for example by exploiting technology through home-based cardiac rehabilitation, which was offered in only 38 countries. Delivery in these settings is just as effective at reducing death in heart patients,鈥� says Grace.

The protocol of this global study was endorsed by several international organizations, including the World Heart Federation.

91亚色聽champions new ways of thinking that drive teaching and research excellence. Our students receive the education they need to create big ideas that make an impact on the world. Meaningful and sometimes unexpected careers result from cross-disciplinary programming, innovative course design and diverse experiential learning opportunities. 91亚色 students and graduates push limits, achieve goals and find solutions to the world鈥檚 most pressing social challenges, empowered by a strong community that opens minds. 91亚色 U is an internationally recognized research university 鈥� our 11 faculties and 25 research centres have partnerships with 200+ leading universities worldwide. Located in Toronto, 91亚色 is the third largest university in Canada, with a strong community of 53,000 students, 7,000 faculty and administrative staff, and more than 300,000 alumni. 91亚色 U's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education. 聽

Media Contact:聽聽Anjum Nayyar, 91亚色 Media Relations, 416 736 2100 ext. 44543聽anayyar@yorku.ca

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TORONTO, October 23, 2018 鈭� New research from 91亚色 on fat tissue is providing an important clue as to how females stay healthier than males, even as their body fat increases.

Published today in聽Frontiers in Physiology听鈥撀�Vascular Physiology, the research focusses on the differences between abdominal fat in obese male and female mice. A team of researchers under the direction of Professor Tara Haas found that the abdominal fat on female mice had more blood vessels than the fat on male mice, and that this protected the health of the female mice as they gained fat from eating a high-fat diet.

Males and females develop fat tissue differently and also differ in susceptibility to cardiovascular disease, insulin resistance and diabetes. However, the underlying biology behind why fat tissue in females is more protective against these conditions was not well understood, says Haas, a professor in the School of Kinesiology and Health Science, Faculty of Health.

Blood vessels are critical for maintaining healthy fat tissue by ensuring that the expanding fat cells are supplied with enough oxygen and nutrients, so the researchers looked at whether the abilities of the fat tissue to grow blood vessels and maintain healthy fat tissue would be different between males and females.

鈥淲e found that female mice have a higher number of blood vessels in their fat than males, and that females increase the number of blood vessels as they are fed a high fat diet, while males do not. We concluded that this response enabled females to maintain healthier fat and better insulin sensitivity,鈥� says Haas.

Martina Rudnicki, a 91亚色 post-doctoral associate and first author of the study, pointed out that the study was unique because it focused on the differences in male and female fat tissue in the abdominal area. Although fat accumulates in different regions of the body, it is abdominal fat that is closely linked with increased risk of developing diabetes, particularly in males. So, the fact that females grow new blood vessels in this abdominal fat during weight gain may exert a health advantage for females.

The sex differences in the fundamental cellular processes that regulate the growth of blood vessels were unappreciated in the past, said Haas. It is important to understand them because they may contribute to an individual鈥檚 susceptibility to develop serious obesity-related health complications such as diabetes, heart disease and cancer, ultimately impacting the health of more than 5.3 million Canadian adults.

The research team plans to confirm these findings in human samples. While it is clear that females also develop health problems with obesity, the fact that there was such a difference in the vascularization in male and female fat may mean it would be more effective to have different treatments for males and females.

91亚色 champions new ways of thinking that drive teaching and research excellence. Through cross-disciplinary programming, innovative course design, diverse experiential learning and a supportive community environment, our students receive the education they need to create big ideas that make an impact on the world. Located in Toronto, 91亚色 is the third largest university in Canada, with a strong community of 53,000 students, 7,000 faculty and administrative staff, and more than 300,000 alumni.

Watch Professor Haas explain findings in this

91亚色 U's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education.

Media Contact:

Anjum Nayyar, 91亚色 Media Relations, 416-736-2100 ext. 44543,聽anayyar@yorku.ca

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