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Why cardiac rehabilitation? ‘Cinderella’ or an evidence-based pillar of care?

Cardiac rehabilitation is often referred to as the “Cinderella” of cardiovascular medicine because it is historically underutilized and underappreciated compared to other aspects of cardiac care, despite its significant benefits and evidence-based foundation. However, it is more accurately described as an evidence-based pillar of care.

Dr Kublan

Here’s why cardiac rehabilitation is considered an essential component of cardiovascular care:

1. **Evidence-based benefits**: Numerous studies have demonstrated the effectiveness of cardiac rehabilitation in improving outcomes for individuals with various cardiovascular conditions, including heart failure, coronary artery disease, and after cardiac surgery or procedures. These benefits include improved exercise capacity, reduced risk of hospitalizations, decreased mortality rates, and enhanced quality of life.

2. **Clinical guidelines**: Major cardiovascular organizations, including the American Heart Association, American College of Cardiology, and European Society of Cardiology, endorse cardiac rehabilitation as an integral part of the management of cardiovascular diseases. Guidelines recommend cardiac rehabilitation for eligible patients as a class I recommendation, indicating strong evidence and consensus for its use.

3. **Multifaceted approach**: Cardiac rehabilitation programs offer a comprehensive, multidisciplinary approach to cardiovascular care. They typically include structured exercise training, education on heart-healthy lifestyle behaviors (such as diet, smoking cessation, and medication adherence), psychosocial support, and risk factor modification. This holistic approach addresses the multifactorial nature of cardiovascular diseases and promotes long-term health and well-being.

4. **Cost-effectiveness**: Despite initial costs, cardiac rehabilitation has been shown to be cost-effective in the long term by reducing hospitalizations, preventing complications, and improving overall health outcomes. Investing in cardiac rehabilitation can lead to significant healthcare savings and better utilization of resources.

While cardiac rehabilitation may have been overlooked or marginalized in the past, its evidence-based benefits and importance in cardiovascular care are increasingly recognized. Efforts to promote awareness, improve accessibility, and integrate cardiac rehabilitation into routine clinical practice are essential for optimizing outcomes and enhancing the quality of care for individuals with cardiovascular diseases. Therefore, rather than being a “Cinderella” of cardiovascular medicine, cardiac rehabilitation should be acknowledged and valued as a cornerstone of evidence-based care.


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