Cardiovascular diseases cause more deaths annually than any other disease.1 It is possible to successfully reduce cardiac risk factors in people with coronary heart disease (CHD) with secondary prevention interventions. However, many people with CHD do not take part in these programmes. Recent data show that 47% of people discharged following myocardial infarction, percutaneous coronary intervention and coronary artery bypass surgery in England, Wales and Northern Ireland between 2013 and 2014 took part in a cardiac rehabilitation programme.2

One way to improve access to these programmes is to provide programmes at home. A previous Cochrane review reported the effectiveness of home-based programmes compared with centre-based cardiac rehabilitation programmes.3 No differences between these programmes in the number of clinical events, exercise capacity, blood pressure, total cholesterol, proportion of smokers or health-related quality of life (HRQOL) were reported.

Secondary prevention programmes can also be delivered through the Internet. Such interventions offer low-resource and scalable solutions at a time when the rising prevalence of heart disease and economic pressures on health services are demanding low-cost innovations. Delivery of interventions via the Internet is also expected by an ever more connected population, including those in older age groups likely to be more affected by CHD, who are increasingly familiar with using online services, unrestricted by time or geographic location, in many areas of their …