Prevención y rehabilitación de la enfermedad cardiovascular: papel de la asistencia primaria

Prevention and rehabilitation in cardiovascular disease: the role of primary care RESUMEN Los programas de rehabilitacion cardiaca y prevencion secundaria han demostrado ser el metodo mas eficaz para disminuir la morbimortalidad de las enfermedades cardiovasculares. A pesar de dichos beneficios, su desarrollo en los diferentes paises es muy variable y, en la mayoria, insuficiente. En Espana existen pocas unidades de rehabilitacion cardiaca multidisciplinarias, por lo que el numero de pacientes que tienen acceso no supera el 5% de las indicaciones. En nuestro pais, estos programas se realizan habitualmente en unidades hospitalarias; sin embargo, existen diferentes tipos de programas segun las necesidades de cada paciente y el grado de supervision que el riesgo de complicaciones requiera. Los pacientes considerados de bajo riesgo podrian realizar programas de rehabilitacion cardiaca multidisciplinarios en los centros de salud, bajo la supervision directa de los diferentes profesionales de atencion primaria.  Palabras clave: Rehabilitacion cardiovascular, prevencion secundaria, atencion primaria. ABSTRACT Cardiac rehabilitation and secondary prevention programs have been shown to provide the most effective way of reducing the morbidity and mortality associated with cardiovascular disease. Despite the evidence of clinical benefits, program implementation has varied substantially between countries and is inadequate in the majority. In Spain, there are only a few multidisciplinary cardiac rehabilitation units, which means that less than 5% of patients with the appropriate indications have access to them. In the country, these programs are usually implemented in hospital departments. However, there are many different types of program, which vary according to the patient's needs and to the level of supervision required to deal with the risk of complications in each individual. Patients regarded as being at a low risk could participate in multidisciplinary cardiac rehabilitation programs based in health centers, under the direct supervision of health-care professionals working in primary care.  Key words: Cardiovascular rehabilitation, secondary prevention, primary care.