Abstract
Cardiac rehabilitation involves delivery of structured exercise, education and risk reduction, in a cost-effective manner. Robust evidence demonstrates it reduces mortality up to 25%, improves functional capacity, as well as decreases re-hospitalization. Despite its benefits, and clinical practice guideline recommendations to refer cardiac patients, cardiac rehabilitation programs are grossly under-used. Worldwide, there is low availability of cardiac rehabilitation; only 38.8% of countries globally have cardiac rehabilitation programs. Specifically, 68.0% of high-income and 23% of lower middle income class have cardiac rehabilitation. Cardiac rehabilitation density estimates ranged from 1 program per 0.1–6.4 million inhabitants. Cardiac rehabilitation availability is much lower than that of other evidence-based secondary prevention therapies, such as revascularization and pharmacological therapies. Multi-level strategies to augment cardiac rehabilitation capacity and availability at national and international levels such as supportive public health policies, systematic referral strategies, and alternative models of delivery are needed.
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