Management after coronary by-pass graft surgery: a rehabilitation course induces life style changes which may improve long term graft survival.

Too many coronary artery by-pass grafts block within 10 years. Smoking, one risk factor is well managed with over 80% giving up peri-operatively, but hyperlipidaemia is not. Only 27% of such patients on a rehabilitation course knew their cholesterol and 32% had received no dietary advice. As baseline mean cholesterol was high (7.03 mmol/l) this may be a serious omission. After rehabilitation patients have complied for a mean 16.6 months with recommendations on diet (97% remain on a low fat diet) and exercise (now over 3 sessions per week, a level at which long term cardiovascular benefit may be expected). Within 4 months a significant (14%) fall in total cholesterol was achieved. Rehabilitation after by-pass grafting induces life style changes which may improve long term graft survival and should be made more available.