Dr. Randal J. Thomas

Great to be here with you. Thanks.

Great to be here with you. Thanks.

Fair. Now, it's a really good place to start. It may seem pretty logical to us today that rehabilitation after a cardiac event just makes sense because it does. It hasn't always made sense. And in fact, looking back into the like in the early 1900s, even into the mid 1900s, it was thought that activity in people with heart conditions was harmful.

Fair. Now, it's a really good place to start. It may seem pretty logical to us today that rehabilitation after a cardiac event just makes sense because it does. It hasn't always made sense. And in fact, looking back into the like in the early 1900s, even into the mid 1900s, it was thought that activity in people with heart conditions was harmful.

And he was, in fact, advised against in most cases. A good example of a turning point occurred when Dwight Eisenhower was serving as president of the United States and he had a heart attack. And all of his specialists gathered around him and said, okay, you need to get bed rest for six months. You need to curl back on your work in the White House. There's no way you can run for reelection.

And he was, in fact, advised against in most cases. A good example of a turning point occurred when Dwight Eisenhower was serving as president of the United States and he had a heart attack. And all of his specialists gathered around him and said, okay, you need to get bed rest for six months. You need to curl back on your work in the White House. There's no way you can run for reelection.

And, you know, you just need to kind of take it easy for the rest of your life. So he called in a specialist from Boston, Paul Dudley White, who was one of the grandfathers of preventive cardiology. And Paul Dudley White said, No, actually, exercise is gonna be good for you. You need to quit smoking. And you need to be active.

And, you know, you just need to kind of take it easy for the rest of your life. So he called in a specialist from Boston, Paul Dudley White, who was one of the grandfathers of preventive cardiology. And Paul Dudley White said, No, actually, exercise is gonna be good for you. You need to quit smoking. And you need to be active.

And we're going to control your blood pressure with the medications that they had at the time. And he got him back, you know, more and more active and He certainly had some problems with his heart after that, but he was able to recover. And it was kind of a turning point for preventive cardiology in a way where people started to look at this opportunity.

And we're going to control your blood pressure with the medications that they had at the time. And he got him back, you know, more and more active and He certainly had some problems with his heart after that, but he was able to recover. And it was kind of a turning point for preventive cardiology in a way where people started to look at this opportunity.

And there were studies at that time that started to look at some simple things like instead of having people at bed rest for six weeks in the hospital after a heart attack, let's have them sit up in a chair. And they found that people did better. And then they said, well, why don't we walk them up and down the hallway and And they did some studies along those lines.

And there were studies at that time that started to look at some simple things like instead of having people at bed rest for six weeks in the hospital after a heart attack, let's have them sit up in a chair. And they found that people did better. And then they said, well, why don't we walk them up and down the hallway and And they did some studies along those lines.

And sure enough, people did better. It felt better, recovered quicker, got back to work quicker and so forth. And then they started to be even more bold and said, why don't we take it to the outpatient setting? And the doctors at the time that were pursuing this were really, they faced a lot of opposition. People thought it was too dangerous. These are people with heart conditions.

And sure enough, people did better. It felt better, recovered quicker, got back to work quicker and so forth. And then they started to be even more bold and said, why don't we take it to the outpatient setting? And the doctors at the time that were pursuing this were really, they faced a lot of opposition. People thought it was too dangerous. These are people with heart conditions.

Their hearts are going to burst. There's all kinds of concerns. And sure enough, as they implemented the program in the outpatient setting, they showed that it could be done safely and effectively. So that's kind of taking you up to about 1980. From 1980 on, what started to become clear was that it was more than exercise. It was more than like the physical rehabilitation side of things.

Their hearts are going to burst. There's all kinds of concerns. And sure enough, as they implemented the program in the outpatient setting, they showed that it could be done safely and effectively. So that's kind of taking you up to about 1980. From 1980 on, what started to become clear was that it was more than exercise. It was more than like the physical rehabilitation side of things.

It's interesting that physical therapy, developed after the polio pandemic and after World War I and World War II, when there were so many people with debilitating conditions, they needed help to recuperate. So cardiac rehabilitation kind of came in the shadows of that. But then in the 1980s, it was clear there was more to it than just getting people to be more active.

It's interesting that physical therapy, developed after the polio pandemic and after World War I and World War II, when there were so many people with debilitating conditions, they needed help to recuperate. So cardiac rehabilitation kind of came in the shadows of that. But then in the 1980s, it was clear there was more to it than just getting people to be more active.

That's when cholesterol and blood pressure and smoking and other risk factors became more clear and treatment for them became more available. And so from that point on, from the 1980s on, cardiac rehabilitation became more of a multidimensional program to implement a prevention program in individuals with heart disease.

That's when cholesterol and blood pressure and smoking and other risk factors became more clear and treatment for them became more available. And so from that point on, from the 1980s on, cardiac rehabilitation became more of a multidimensional program to implement a prevention program in individuals with heart disease.