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Cardiac rehabilitation: the gateway for secondary prevention
  1. Sherrie Khadanga1,
  2. Patrick Savage1,
  3. Steven Keteyian2,
  4. Blair Yant3,
  5. Diann Gaalema3,
  6. Philip Ades1
  1. 1Medicine, University of Vermont, Burlington, Vermont, USA
  2. 2Preventive Cardiology, Henry Ford Hospital, Detroit, Michigan, USA
  3. 3Psychiatry, University of Vermont, Burlington, Vermont, USA
  1. Correspondence to Dr Sherrie Khadanga, Medicine, University of Vermont, Burlington, Vermont, USA; sherrie.khadanga{at}


Cardiac rehabilitation (CR) is a multidisciplinary supervised programme which typically consists of tailored exercise and education on lifestyle management and risk factor modification in cardiac patients. Participation in CR reduces morbidity and mortality, while improving quality of life following major cardiovascular events. Despite the benefits of CR, it is underutilised, generally in the 20%–30% range for eligible patients. Participation and adherence rates are particularly suboptimal in vulnerable populations, such as those of lower socioeconomic status and women. Interventions such as automated referral to CR or hybrid/virtual programmes can increase enrolment to CR. This review summarises the components of CR and provides recommendations for providers regarding participation and adherence. To better engage a larger proportion of CR-eligible patients, CR programmes may need to expand or adjust ways to deliver secondary prevention.

  • Cardiac Rehabilitation
  • Risk Factors

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  • Contributors All authors were involved in the manuscript process, including planning, writing and revising the manuscript. Tables 1 and 2 were created by SKh, BY and PA. Figures 1 and 2 were created by SKh, BY and PA. Figure 3 was created by SKe.

  • Funding The research was supported by the National Institute of General Medical Sciences (P20GM103644) and the NHLBI Division of Intramural Research (R33HL143305).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Author note References which include a * are considered to be key references.