World Heart Federation Roadmap on cardiac rehabilitation: a pathway to lifelong cardiovascular health
Julie RedfernRandal J. ThomasTom BriffaLilian MbauRobyn GallagherDion CandelariaIrene GibsonWen‐Chih WuAlexis L. BeattyGabriela Lima de Melo GhisiAlice NamanjaDawn C. ScantleburyAbraham Samuel BabuGiulliano GardenghiYihong SunAashish ContractorAna AbreuRoque Daniel GonzálezPat O’Donnell丁荣晶D.R. WoodSidney C. Smith
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Why the study?
Health-care systems face an aging population and persistent unhealthy lifestyles leading to more individuals living longer with cardiovascular disease, necessitating consolidated global efforts to enhance equitable access to cardiac rehabilitation and secondary prevention.
Key Points
- To present a united, forward-looking global vision and actionable framework that overcomes existing barriers to cardiac rehabilitation and achieves lifelong cardiovascular health.
- Developed through a three-stage iterative process consisting of an international survey, a global forum, and drafting by an international expert writing group endorsed by the International Council of Cardiovascular Prevention and Rehabilitation.
- Administered a 9-item survey in July 2024 to clinicians and experts (N=327) across 50 countries, with 55% having >11 years of professional experience.
- Noted that despite clinical recommendations, global survivors experience low uptake, including 30% referral, 9% attendance, and <5% completion among eligible individuals.
- Highlighted that adherence to evidence-based medications and lifestyle modifications typically declines within 6 months of an acute cardiac event.
- Identified five core roadblocks and formulated solutions focused on lifelong health, patient-clinician engagement, flexible care models, workforce strengthening, and policy advocacy.
Structured PICO
P
Population
327 clinicians and experts from 50 countries surveyed to gather perspectives on cardiovascular health programs globally.
I
Intervention
World Heart Federation Roadmap strategies for cardiac rehabilitation and secondary prevention
This World Heart Federation Roadmap provides a strategic global framework to overcome barriers to cardiac rehabilitation and promote lifelong cardiovascular health.
Ask about this paper
Answers are grounded in this paper and cite their sources.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The Roadmap advocates for reframing cardiac rehabilitation from a simple exercise program to a comprehensive, life-long model of secondary prevention. It identifies five key roadblocks—including limited patient and clinician engagement, and outdated care models—and provides actionable, patient-centered solutions to ensure equitable access and long-term cardiovascular health.”
“Underuse despite Class I evidence: Awareness, workforce gaps, and perceived ROI limit referrals—especially in low-resource settings and for women and other under-represented groups.”
“Hybrid & tele-rehab work when flexible: Combine in-person assessment with remote follow-up (phone, apps, activity trackers) and offer on-site check-ins to maximize reach, safety, and adherence.”
Implication
Clinicians should apply the roadmap to close equity gaps in cardiac rehabilitation access; extends Class I evidence by targeting global policy and workforce barriers.
Abstract
With an ageing population and the persistence of unhealthy lifestyle behaviours, health-care systems are challenged by a growing number of individuals living longer with cardiovascular disease and its sequelae. The evolution of cardiac rehabilitation, from a group exercise-based programme to encompassing all aspects of secondary prevention, has led to the ultimate objective of achieving lifelong cardiovascular health for all. In this World Heart Federation Roadmap, we present a united and forward-looking vision to consolidate global and collaborative efforts that enhance equitable access, improve patient outcomes and ensure value-based health care. The Roadmap outlines a reframing of terminology and interconnected solutions founded on unity, person-centredness and being future-focused. The five key roadblocks and widely applicable solutions are interlinked and include having a greater emphasis on lifelong cardiovascular health, better engagement among patients and clinicians, a greater emphasis on new models of care, workforce strengthening and support for strong advocacy and policy. We present a series of practical solutions and successful international case studies. The next steps are to facilitate local and regional implementation and evaluation strategies. A shift to systems, policy and advocacy thinking is crucial for the sector, with a view to long-term investment to meet growing demands. This World Heart Federation Roadmap is endorsed by the International Council of Cardiovascular Prevention and Rehabilitation.
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Cite This Study
Redfern et al. (2026) conducted a review in Cardiovascular disease (cardiac rehabilitation) (n=327). World Heart Federation Roadmap on cardiac rehabilitation was evaluated on Perspectives on challenges and enablers in the delivery of cardiovascular health programs. The World Heart Federation Roadmap outlines five key roadblocks and interconnected solutions to enhance equitable access and improve patient outcomes in cardiac rehabilitation.
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