Exercise-based cardiac rehabilitation reduces hospital admissions by a third and heart attack risk by more than a quarter, as well as\u00a0remaining\u00a0beneficial in the long term, a new Cochrane review finds.\u00a0The evidence also suggests that newer home-based and digitally supported cardiac rehabilitation programs can be just as effective as traditional center-based services.\u00a0<\/p>\n
Coronary heart disease is the single most common cause of death globally. It\u00a0can lead to\u00a0chest pain, heart attacks,\u00a0or stroke.\u00a0Cardiac rehabilitation programs\u00a0are widely recommended\u00a0following a cardiac event, with exercise recognized as a core\u00a0component.\u00a0<\/p>\n
Effective and inexpensive intervention\u00a0<\/p>\n
The researchers, led by the University of Glasgow,\u00a0analyzed\u00a0107 randomized controlled trials involving 26,886 people with\u00a0coronary\u00a0heart disease.\u00a0Most participants had experienced a heart attack,\u00a0undergone heart procedures, or experienced some sort of chest pain.\u00a0Women were underrepresented, making up only 17% of participants despite being included in most studies.\u00a0<\/p>\n
The overall results show that,\u00a0compared with no program,\u00a0exercise-based cardiac rehabilitation reduces\u00a0heart attacks by 28%,\u00a0reduces all-cause hospital admissions by 35%, and\u00a0probably\u00a0reduces\u00a0deaths.\u00a0<\/p>\n
Participants\u00a0also\u00a0reported better physical functioning, general health, vitality, social functioning, and mental wellbeing.\u00a0These benefits were seen across several validated quality-of-life measures.\u00a0<\/p>\n
Our review shows that exercise-based cardiac rehabilitation can reduce the risk of heart attack and hospital admission while helping people return to healthier, more active lives.”<\/p>\n
Dr. Grace Dibben, lead author, University of Glasgow<\/p>\n
“Many people lose confidence after a heart attack or cardiac procedure and worry that physical activity could be dangerous,” Dr Dibben adds.\u00a0“Appropriately prescribed exercise is not only safe for most\u00a0patients, but\u00a0can play a vital role in recovery and long-term heart health.”\u00a0<\/p>\n
Growing evidence for modern rehabilitation models<\/p>\n
This new update included 22 new trials featuring just under 3,500 participants, incorporating more recent data into the final results. The more recent studies included participants based in low- and middle-income countries (LMICs) and tested home-based and digital cardiac rehabilitation programs.\u00a0<\/p>\n
“This review confirms\u00a0that\u00a0exercise is a great tool for\u00a0improving the\u00a0overall\u00a0health of people with coronary heart disease,” says\u00a0Professor\u00a0Rod Taylor, senior author from the University of\u00a0Glasgow. “By adding newer studies to this\u00a0update,\u00a0we’re\u00a0able to see that\u00a0digital programs work as well as in-person programmes, which really changes the game here.\u00a0These approaches may help us reach people who cannot attend traditional center-based services.”\u00a0<\/p>\n
Several studies in this update were conducted in LMICs, examining\u00a0different types\u00a0of exercise in different countries;\u00a0for example, yoga in India and tai chi in China. The authors suggest this not only improves the relevance of the evidence base, but that some populations may find rehabilitation built around traditional and cultural forms of exercise more appealing than conventional, machine-based rehab.\u00a0<\/p>\n
Low uptake despite\u00a0evidence-backed\u00a0benefits\u00a0<\/p>\n
Despite\u00a0strong evidence\u00a0supporting cardiac rehabilitation, uptake\u00a0remains\u00a0a challenge in many healthcare systems.\u00a0Various guidelines, including NICE\u00a0in the UK,\u00a0recognize cardiac rehabilitation as\u00a0a key\u00a0component\u00a0following a cardiac event.\u00a0However, cardiac rehabilitation continues to be widely underused\u00a0with\u00a0generally low\u00a0participation rates.\u00a0According to the\u00a02025\u00a0National Audit of Cardiac Rehabilitation (NACR) report, the uptake\u00a0of cardiac rehabilitation for\u00a0patients\u00a0with acute coronary syndrome\u00a0was 44.5% in England and 71.3% in Wales.<\/p>\n
The authors explain that\u00a0many patients face barriers to attending traditional hospital-based programs, including work commitments, transport\u00a0challenges,\u00a0and caring responsibilities.\u00a0This can disproportionately\u00a0impact\u00a0groups like women, older adults, and deprived communities the hardest.\u00a0<\/p>\n
“Exercise-based cardiac rehabilitation is an inexpensive and cost-effective intervention, but right now it’s underfunded and unprioritized,” explains Dr Dibben. “We want this option to be available to everyone.\u00a0This\u00a0new research shows you don’t even have to go into a rehab center to benefit\u00a0\u2013 you can participate from home and still see the benefits.”\u00a0<\/p>\n
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