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Making cardiac rehabilitation more available and affordable
  1. Carl J Lavie,
  2. Sergey Kachur,
  3. Richard V Milani
  1. John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana, USA
  1. Correspondence to Dr Carl J Lavie, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA; clavie{at}ochsner.org

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Substantial evidence demonstrates the critical role of cardiac rehabilitation and exercise training (CRET) programmes following major coronary heart disease (CHD) events.1 Although a recent meta-analysis has questioned the impact of CRET on total mortality,2 there is still substantial evidence that this therapy reduces cardiovascular disease (CVD) mortality and improves overall prognosis following major CHD events.1–3 Additionally, this therapy has dramatic effects to improve CHD risk factors, exercise capacity, psychological risk factors associated with higher mortality and overall health-related quality of life (HRQoL).1 3 4

However, as we recently reviewed, the majority of candidates for CRET do not actually attend these programmes,1 4 and greater efforts are needed to make these programmes more available to patients in rural areas, those which transportation or employment issues, as well as efforts to make this therapy even more ‘cost effective’ for our patients.

In their Heart paper, Maddison and colleagues5 from Australia and New Zealand report on a randomised controlled trial of CRET, with …

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