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Objective: Coronary heart disease (CHD) is a major cause for mortality and morbidity among Indians. However, the focus on lifestyle measures in the prevention of CHD in the country is abysmally low. We aimed to analyse the outcomes of a comprehensive CHD prevention/rehabilitation program in South India. Methods: All patients enrolled between May 2014 and April 2015 with establishedCHD (n = 32) orwith documented risk-factors andno CHD (n = 28) were included in the study. Patients attended 1–2 sessions per week for 6–12 weeks. Each session lasted 90–100min and included an exercise component and an education/counselling component on diet, activity, compliance to therapy, risk-factor modification and psychosocial aspects. Apart from clinical and family history, resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), bodymass index (BMI), waist–hip ratio and functional capacity using treadmill test (TMT) or 6 min walk test (6MWT) were documentedbefore (pre) andafter (post) theprogram.Adherencewas considered good if a patient attended >50% of the sessions enrolled andpoor if≤50%. Fischer's exact test and student's t-testwere used to compare categorical and continuous variables respectively; p value < 0.05 was considered statistically significant. Results: SubjectswithCHDwereolder (61 10yearsvs50 15years, p = 0.002), predominantlymales (84%vs 57%, p = 0.02), showedbetter adherence (84% vs 61%, p = 0.046) and attendedmore sessions (11.1 6.4 vs 6.9 3.6, p = 0.03) than non-CHD subjects. In the CHD group, medical therapywasdocumented inall (100%),CABGin4 (12%), PTCA in 3 (9%) and heart failure in 5 (16%) subjects. Among all (n = 60) enrolled subjects, 37 (62%) completed their program and 23 (38%) could not complete due to various reasons. Post-programevaluation showedsignificant improvement in cardiac symptoms, BMI, SBP and functional capacity (Table 1). The 6MWT seems to be an efficient and reliable tool for functional capacity assessment in our setting. Conclusion: Cardiac rehabilitation, a key component in the management of CHD, is under-utilised in India. This study shows that an exercise-cum-education program has significant benefits in a South Indian cohort and can potentially be incorporated in the routine management of all patients with (risk of) CHD.

Burden of cardiovascular risk in young, apparently healthy individuals in the Indian sub-continent: Time for intervention?