Cardiac rehabilitation: why is it an underused therapy?: Table 1

This editorial refers to ‘Cardiac rehabilitation and survival in a large representative community cohort of Dutch patients’[†][1], by H. de Vries et al ., on page 1519. During the last decades, cardiac rehabilitation (CR) has evolved from a simple patient monitoring system for the safe return to normal physical activities to a multidisciplinary approach that focuses on patient education, individually tailored exercise training, modification of the risk factors, and the overall well-being of cardiac patients. The benefits of CR include reduction in mortality, symptom relief, smoking cessation, improved physical fitness, risk factor modification, and improved overall psychosocial well-being.1–3 Unfortunately, CR still remains underutilized among patients with cardiovascular diseases mainly because of referral problems, poor enrolment and support, and various local reasons due to limited resources. A problem that healthcare systems are facing in all developed countries is the increase of the ageing population with various cardiovascular diseases and frailty. Coronary heart disease (CHD) is the most common type of heart disease, and it manifests as chest pain and myocardial infarction. Patients with cardiovascular diseases are a great challenge for secondary prevention measures, and recent research developments in CR have demonstrated that tremendous benefits can be derived from the optimal use of CR in patients recovering from an acute CHD event or heart failure (HF), as well as after cardiac surgery.1 A crucial point is to consider CR not as exercise training only, but also as a programme based on the individual's requirements, aiming at the improvement of the quantity and quality of life by means of: reduction of the risk factors, such as smoking and cholesterol levels, modification of dietary habits, increase and maintenance of exercise training and its intensity, psychological support, and guidance on returning to work. The scope of contemporary … [1]: #fn-2