The role of cardiac rehabilitation in improving cardiovascular outcomes

Taylor, R. S. , Dalal, H. M. and McDonagh, S. T.J. (2022) The role of cardiac rehabilitation in improving cardiovascular outcomes. Nature Reviews Cardiology, 19(3), pp. 180-194. (doi: 10.1038/s41569-021-00611-7) (PMID:34531576) (PMCID:PMC8445013)

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Cardiac rehabilitation is a complex intervention that seeks to improve the functional capacity, wellbeing and health-related quality of life of patients with heart disease. A substantive evidence base supports cardiac rehabilitation as a clinically effective and cost-effective intervention for patients with acute coronary syndrome or heart failure with reduced ejection fraction and after coronary revascularization. In this Review, we discuss the major contemporary challenges that face cardiac rehabilitation. Despite the strong recommendation in current clinical guidelines for the referral of these patient groups, global access to cardiac rehabilitation remains poor. The COVID-19 pandemic has contributed to a further reduction in access to cardiac rehabilitation. An increasing body of evidence supports home-based and technology-based models of cardiac rehabilitation as alternatives or adjuncts to traditional centre-based programmes, especially in low-income and middle-income countries, in which cardiac rehabilitation services are scarce, and scalable and affordable models are much needed. Future approaches to the delivery of cardiac rehabilitation need to align with the growing multimorbidity of an ageing population and cater to the needs of the increasing numbers of patients with cardiac disease who present with two or more chronic diseases. Future research priorities include strengthening the evidence base for cardiac rehabilitation in other indications, including heart failure with preserved ejection fraction, atrial fibrillation and congenital heart disease and after valve surgery or heart transplantation, and evaluation of the implementation of sustainable and affordable models of delivery that can improve access to cardiac rehabilitation in all income settings.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Taylor, Professor Rod
Authors: Taylor, R. S., Dalal, H. M., and McDonagh, S. T.J.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Nature Reviews Cardiology
Publisher:Nature Research
ISSN (Online):1759-5010
Published Online:16 September 2021
Copyright Holders:Copyright © 2021 Springer Nature Limited
First Published:First published in Nature Reviews Cardiology 19(3): 180-194
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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