Primary Prevention
"I regularly meet people whose lives have been affected by heart disease. This frustrates me since I know that some simple lifestyle changes could have prevented a lot of these affects from happening in the first place."
- Tom Hastings RGN, Clinical Nurse Specialist in Cardiology
The aim of primary prevention is to reduce the risk of developing symptomatic heart problems or other health problems. This can be done by identifying risk factors.
Risk factors are conditions or habits that make a person more likely to develop heart problems. Non-invasive diagnostic technology has improved our ability to detect the early stages of heart disease. By acting on our findings, we can prevent heart disease from having a serious impact on people's lives.
Common non-invasive diagnostic tests for the assessment of heart disease include:
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CT Coronary Angiogram (CTCA)
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Coronary Angiogram
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Stress Echocardiogram
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Myocardial Perfusion Scintigraphy (MPS)
Who is it for?
Suitable people for primary prevention are those who suffer from or are at risk of:
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High blood pressure (hypertension) - above 140/90
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High Cholesterol (hyperlipidaemia) - total cholesterol level more than 5
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Diabetes - Type 1 & 2
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Smoking - those who still smoke or stopped within the last 5 years
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Being overweight - BMI of more than 25
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Having a family history of heart disease - siblings, parents or grandparents.
Other risk factors that also play a role in the development of heart disease include:
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Age / Gender - Men older than 45, women older than 55
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Stress / Anxiety
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Ethnicity
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Physical inactivity - less than 150 minutes of moderate exercise per week
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Excessive alcohol consumption - 3-4 units per day for men, 2-3 units for women.
When can I start Cardiac Rehabilitation?
Unless you have any contraindications (any other health issues which means you are unsuitable for rehabilitation), then you should be able to commence a rehabilitation programme as soon as you want. You can consult your GP / Cardiologist or other healthcare specialist before you take up a programme if you wish, or you can read more about rehabilitation programmes here.
How does it work?
You can refer yourself by simply contacting us. We can then gather the relevant information. Alternatively, you can ask your GP or healthcare professional to refer you. Frequently, your Cardiologist or Nurse Specialist will refer you directly.
Once you have been referred to Heartsure, a member of the team will contact you directly. You will be asked to provide some basic information to confirm your identity and to give us an indication of your medical history, following which a member of our team will discuss the path to recovery. Some questions that might be asked are:
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Are you symptom free?
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What are your current activity levels?
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Are you complying with your doctors recommendations and taking your medication regularly?
An Initial Assessment will then be booked.
Initial Assessment (IA)
The initial assessment is an individual session with our clinician. This is the first meeting of your rehabilitation programme where our clinician will discuss your diagnosis and what it means for you. Whether you have had a heart attack, or you suffer from Angina or valve disease, our clinician will discuss the treatment you have had and how this benefits you.
During the initial assessment, the clinician will also discuss your medication and your lifestyle to assess if there may be any factors that affect your health. You can use this as an opportunity to ask questions to gain a better understanding of your prescription medication.
After this, our clinician will take some baseline observations to better understand your health, which can include:
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Resting ECG
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Blood Pressure
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Height & Weight (BMI)
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Lung Function
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Heart Rate
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Oxygen Saturations
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Peak flow test
Your clinician will discuss the normal parameters for these observations, and explain what your results mean.
Lastly, an exercise assessment will help us to identify any mobility problems that you may have. A simple walking test will be performed to assess your heart's response to exercise. We will attach a small monitor to record your heart rate and you will become aquatinted with a medically supervised exercise circuit. Here you will learn the correct way to exercise for your heart. Using heart rate monitors and other exercise assessment tools, we will aim to gain an understanding of the level of exercise you need to achieve.
A routine session will consist of:
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A simple warm-up, which will include stretching exercises
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A 6-8 station exercise circuit specifically designed for cardiac patients
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An extended cool down period with progressive stretches
Supporting Equipment - We can offer a Polar activity device (a heart rate monitor and activity tracker). This will allow our clinicians to analyse your activity, track your steps, monitor your sleep and record your heart rate during exercise. We will then devise an action plan and some personal short-and long-term goals. You can find out more about the equipment we offer and prices below under 'covering your care'
Following the Initial Assessment - A comprehensive report and clinic letter, which will include your personal goals and action plan, will be sent to your cardiologist, surgeon, referring clinician or GP.
One-to-One Exercise Sessions - Weekly / regular sessions – with your clinician.
At the start of each weekly or regular session you will have a health check-up which will include your Baseline Observations. There will then be an opportunity to discuss your progress since the last session. We will review any on-going symptoms and identify any problems and successes. If you are using a Polar activity device (see example below), the data collected can be analysed and feedback given. If for any reason your goals have not been achieved, we will review the reasons and work together to get you back on track. Whilst continuing to work with your clinician on the medically supervised exercise circuit, the clinician can adjust and adapt the circuit to suit your needs. At the end of each session we will summarise your achievements and set a plan for the time until your next session.
Discharge / Review Meeting - After a defined period of time from the start of your programme, there will be an appointment with your clinician and a review of your goals. New goals and future action plans will be set. You will then repeat the ‘Exercise Test’ and assess any improvements made in your fitness levels. A summary of goals will be discussed, with new challenges set for any which haven’t yet been reached. An updated progress report will be sent to your cardiologist / surgeon / referring person and GP.
"Successful health behaviour programmes that involve exercise training, physical activity, risk factor management and psychological wellbeing require time to achieve the desired goals."
- The National Audit (2017) - Cardiac Rehabilitation
Covering your Care:
How long will my programme last?
Cases and rehabilitation programmes are assessed on an individual basis. Your clinician will suggest the number of sessions you need. Please note, NHS training programmes are, on average, 8 weeks in duration (excluding the initial assessment and discharge session)
Self-Funding:
Initial Assessment - £250.00
One-to-One Exercise Session - £100.00
Discharge / Review Meeting - £150.00
Appointments are usually 75 minutes long, with the exception of the Initial Assessment which lasts around 2 hours.
Health Insurance:
While some insurance companies do cover our programmes, most do not cover the full course of treatment. Please confirm this with your insurance provider and policy prior to commencing rehabilitation sessions, or contact a member of the team to discuss this further.
For more information about our prices and plans, please find our Rehabilitation fee schedule here.