Cardiac rehabilitation today: programs, their effects and practical guidelines

Cardiac rehabilitation programs started to develop in the early 1970s. At that time the emphasis was on physical training. The goal was early return to work and lowering of mortality. Today, cardiac rehabilitation also includes risk factor modification and stress management. From 1972 to 1986, 22 randomized, controlled trials were performed to evaluate whether cardiac rehabilitation would be able to decrease mortality and improve people's ability to return to work. Although all of them reported an increase in physical working capacity, only one reported a decrease in mortality. However, a meta‐analysis of the 22 trials was reported in 1989. The study found a 20% decrease in total mortality and a 22% decrease in cardiovascular mortality, both significant. This article describes the principles of cardiac rehabilitation and different types of program models with a detailed description of 3 different programs. It also reviews the effect of cardiac rehabilitation on mortality and its use in primary prevention.