Grant: CIHR Fellowship

Cardiovascular Disease (CVD) is the world's number one killer, with more than 80% of deaths occurring in less-developed countries. Yet, people with CVDs in such countries have less access to proven treatments, including secondary prevention therapies (i.e. methods to treat existent disease in early stages before it causes significant incapacities). Cardiac Rehabilitation (CR), which is a comprehensive secondary prevention program (i.e. involves exercise and comprehensive education and counseling), has been shown to reduce deaths and decrease number of days in the hospital and medical costs. While CR is not highly available in these countries, there is a need for a better understanding of the provision of CR in these contexts, and its effects. This study aims to investigate if participation in CR in the less-developed country of Brazil results in better health in cardiac patients.The primary objective will be the assessment of functional capacity (i.e. the capacity to perform a physical function). The secondary objectives specifically are that significant reductions in risk indicators will be achieved among those participating in CR versus usual care, namely blood pressure, obesity, smoking and fat in blood. The tertiary objectives specifically are that exercise behavior, healthy diet, regular use of cardiac medication, and CVD-related knowledge will be significantly greater among those in CR. This study will compare Brazilian patients who have heart problems in 2 groups: 1) attendees of a 12-week CR program and 2) non-attendees (i.e. receiving regular care from their physicians). Functional capacity will be assessed using a test called Shuttle, where subjects are required to walk up and down a 10-meter course. The proposed research is expected to improve the health of Brazilians with CVD, and we anticipate that it will form the basis of our efforts to promote broader implementation of CR and patient access in less-developed countries.