The role of cardiac rehabilitation in the treatment and secondary prevention of cardiovascular disease

One of the most striking developments in recent medical thinking has been the evolution of the philosophy of rehabilitation, or the 'third phase of medical care'. The impact of this discipline on medical practice stems from the widespread intensification in contemporary medical teaching of the concept that delineates the patient's relationship with himself, his family and work and also with the total community. Several observations have progressively led to cardiac rehabilitation being considered an important part of cardiovascular prevention and to the development of various educational programmes and clinical interventions to identify and modify major coronary risk factors and consequently to reduce morbidity and mortality in patients with established heart diseases. In this article, the most recent studies on cardiac rehabilitation programmes are reviewed. We also highlight the need for additional studies in order to evaluate the risk of exercise for patients with diagnosed or occult cardiovascular disease and, especially, to evaluate the role of physical activity relative to other interventions on healthcare costs.