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. 2023 Jul 21;44(28):2515-2525.
doi: 10.1093/eurheartj/ehad225.

Global perspectives on heart disease rehabilitation and secondary prevention: a scientific statement from the Association of Cardiovascular Nursing and Allied Professions, European Association of Preventive Cardiology, and International Council of Cardiovascular Prevention and Rehabilitation

Rod S Taylor  1 , Suzanne Fredericks  2 , Ian Jones  3 , Lis Neubeck  4 , Julie Sanders  5   6 , Noemi De Stoutz  7 , David R Thompson  8 , Deepti N Wadhwa  9 , Sherry L Grace  10   11
Affiliations

Global perspectives on heart disease rehabilitation and secondary prevention: a scientific statement from the Association of Cardiovascular Nursing and Allied Professions, European Association of Preventive Cardiology, and International Council of Cardiovascular Prevention and Rehabilitation

Rod S Taylor et al. Eur Heart J. .

Abstract

Cardiovascular disease is a leading cause of death, morbidity, disability, and reduced health-related quality of life, as well as economic burden worldwide, with some 80% of disease burden occurring in the low- and middle-income country (LMIC) settings. With increasing numbers of people living longer with symptomatic disease, the effectiveness and accessibility of secondary preventative and rehabilitative health services have never been more important. Whilst LMICs experience the highest prevalence and mortality rates, the global approach to secondary prevention and cardiac rehabilitation, which mitigates this burden, has traditionally been driven from clinical guidelines emanating from high-income settings. This state-of-the art review provides a contemporary global perspective on cardiac rehabilitation and secondary prevention, contrasting the challenges of and opportunities for high vs. lower income settings. Actionable solutions to overcome system, clinician, programme, and patient level barriers to cardiac rehabilitation access in LMICs are provided.

Keywords: Access; Cardiac rehabilitation; Cardiovascular diseases; Health services; Secondary prevention.

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Conflict of interest statement

Conflicts of interest R.S.T. reports membership of ESC ACNAP Scientific committee and investigator on the following ongoing externally funded research projects of cardiac rehabilitation: REACH-HFpEF randomized trial funded by UK National Institute of Health Research (NIHR130487); DK:REACH:HF study funded by Danish Heart Foundation (20-R145-A9654-22157), and SCOT:REACH-HF study funded Heart Research UK, and Director of Cardiac Rehabilitation Cochrane Centre. I.J., L.N., N.D.S., S.L.G., J.S., D.R.T., and D.N.W. report no conflicts of interest.

Figures

Graphical Abstract
Graphical Abstract
Barriers to cardiac rehabilitation (CR) access and actionable solutions in low and middle-income countries.
Figure 1
Figure 1
Impact of cadiac rehabilitation on exercise capacity (peak oxygen uptake, mL/kg/min)—summary of results from systematic review/meta-analysis in low- and middle-income countries.
See this image and copyright information in PMC

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