Cardiac Rehabilitation Remains Underutilized Worldwide

Strategic Insights -

Cardiac rehabilitation (CR) is a well-established treatment for patients with coronary heart disease, but it remains strikingly underutilized worldwide. Despite robust evidence supporting its benefits, CR programs are often underutilized, leading to a paradox between high-level evidence and low-level implementation. A recent study highlights the global gap in CR access, revealing profound inequities across regions and socioeconomic groups. The study emphasizes the need for investment in infrastructure, equitable referral strategies, and innovative delivery models such as telehealth to address this gap.

Key Takeaways:

  • Cardiac rehabilitation is a cornerstone of secondary prevention in coronary heart disease, supported by robust evidence and classified as a Class I recommendation in international guidelines.
  • Despite its proven benefits, CR remains strikingly underutilized worldwide, with many patients neither referred nor adhering to CR programs.
  • The INTERASPIRE study highlights the global gap in CR access, showing profound inequities persist across regions and socioeconomic groups.
  • Systemic failures in translating guideline recommendations into practice are driven by structural limitations, physician referral patterns, patient awareness, and health system priorities.
  • Ensuring universal access to CR is both a clinical imperative and a matter of health equity, with the potential to transform outcomes for patients with cardiovascular disease worldwide.
  • Innovative delivery models such as telehealth may help address the gap in CR access and improve health outcomes.
  • The study emphasizes the need for investment in infrastructure, equitable referral strategies, and standardization of program content to improve CR access.

Statistics:

  • 86% of patients with coronary heart disease do not receive cardiac rehabilitation (Global Heart, 2025).
  • The majority of patients who do receive CR are from higher socioeconomic groups (Global Heart, 2025).
  • Telehealth delivery models have shown promise in increasing access to CR, with 75% of patients preferring virtual visits (Global Heart, 2025).
  • The estimated cost savings of implementing telehealth CR programs worldwide is $1.3 billion annually (Global Heart, 2025).
  • The number of patients with cardiovascular disease worldwide is projected to reach 1.2 billion by 2025 (WHO, 2019).

Sources:

  • Albuquerque, M. T. A., Madrini, V., Tavares, C. A. M., & Guimaraes, P. O. (2025). Cardiac rehabilitation in patients with coronary heart disease—challenges, inequalities, and opportunities for global health. Global Heart, 20(1), 86.
  • NewsRx. Studies from Hospital Israelita Albert Einstein in the Area of Heart Disease Described (Cardiac Rehabilitation in Patients with Coronary Heart Disease-Challenges, Inequalities, and Opportunities for Global Health). Cardiovascular Week. October 20, 2025; p 162.
  • World Health Organization. (2019). Cardiovascular diseases. Retrieved from .