Arab–Jewish differences in attending cardiac rehabilitation programs following acute coronary syndrome

Abstract

Intensive efforts to change lifestyle and to manage classical risk factors for coronary heart disease (CHD) via formal programs of cardiac prevention and rehabilitation (CPRP) are strongly recommended as an integral part of proper follow-up care after an acute coronary syndrome (ACS) [ [1] Perk J. De Backer G. Gohlke H. et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2012; ([Published online ahead of print 3 May 2012])https://doi.org/10.1093/eurheartj/ehs092 Crossref Scopus (3060) Google Scholar ]. Despite these recommendations, low participation rates in CPRP prevail among ethnic minorities worldwide [ 2 Valencia H.E. Savage P.D. Ades P.A. Cardiac rehabilitation participation in underserved populations. Minorities, low socioeconomic, and rural residents. J Cardiopulm Rehabil Prev. 2011; 31: 203-210 Crossref PubMed Scopus (63) Google Scholar , 3 Suaya J.A. Shepard D.S. Normand S.L. Ades P.A. Prottas J. Stason W.B. Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation. 2007; 116: 1653-1662 Crossref PubMed Scopus (599) Google Scholar , 4 Thompson D.R. Clark A.M. Cardiac rehabilitation: into the future. Heart. 2009; 95: 1897-1900 Crossref PubMed Scopus (53) Google Scholar ]. Studies carried out in Israel have shown substantially higher CHD incidence, case fatality and mortality in the Arab versus the Jewish population [ 5 Kark J.D. Fink R. Adler B. Goldberger N. Goldman S. The incidence of coronary heart disease among Palestinians and Israelis in Jerusalem. Int J Epidemiol. 2006; 35: 448-457 Crossref PubMed Scopus (41) Google Scholar , 6 Kark J.D. Gordon E.S. Haklai Z. Coronary heart disease mortality among Arab and Jewish residents of Jerusalem. Lancet. 2000; 356: 1410-1411 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar ]. Our objective was to examine whether an ethnic difference, comparing Arab and Jewish patients, exists in participation in CPRP after ACS within a context that strongly encourages such preventive activity, and under universal national health insurance that includes coverage for cardiac rehabilitation.