Secondary Prevention and Cardiac Rehabilitation

Cardiovascular disease (CVD) has been the leading cause of death for the past 20 years and is projected to continue to increase in the coming years as the population ages and the prevalence of obesity and type 2 diabetes increases. Preventive and disease-modifying therapies continue to develop, which reduces CVD mortality, but perpetuates people living with established CVD. Secondary prevention treatments are needed to improve quality of life and reduce adverse outcomes in this growing population. Effective treatments for these diseases include lifestyle modification therapies such as exercise, nutrition, and stress management. In patients with CVD, these behavioral interventions have been shown to reduce risk of hospital readmissions, reduce recurrent cardiovascular events, and improve patients' quality of life. These topics are explored further in this chapter. These components synergistically work together in cardiac rehabilitation (CR) programs to reduce CVD outcomes, with different types of programs providing varying levels of lifestyle modifications. These programs are unique in that they can provide structured, monitored exercise and behavioral counselling and are covered by most insurers. Though these programs have been proven effective, they are still underutilized in countries around the world. Major barriers include low referral rates, lack of understanding the importance of CR, and difficulty attending the programs. Greater awareness and advocacy is needed from both patients and providers to connect the people who need it the most.