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Canadian Journal of Cardiology

Sorting the Wheat From the Chaff in Cardiac Rehabilitation: Who Gets Better and Why?

  • Codie R. Rouleau
    Correspondence
    Corresponding author: Dr Codie R. Rouleau, TotalCardiology Rehabilitation, 2225 Macleod Trail South, Calgary, Alberta T2G5B6, Canada. Tel.: +1-403-296-6924; fax: +1-403-571-6974.
    Affiliations
    TotalCardiology™ Research Network, Calgary, Alberta, Canada

    Department of Psychology, University of Calgary, Calgary, Alberta, Canada
    Search for articles by this author
  • James A. Stone
    Affiliations
    TotalCardiology™ Research Network, Calgary, Alberta, Canada

    Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada
    Search for articles by this author
      Cardiac rehabilitation (CR) is a well-established intervention that involves exercise training, support with healthy lifestyle behaviours, and medical management to treat cardiovascular disease. Overwhelming evidence from randomized controlled trials demonstrates the efficacy of CR for reducing morbidity and mortality across cardiovascular populations with diverse demographic and clinical features.
      • Anderson L.
      • Oldridge N.
      • Thompson D.R.
      • et al.
      Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis.
      This evidence of improved patient outcomes has been pivotal in establishing CR as standard care for most patients with cardiovascular disease. Despite these achievements, a major limitation in the evaluation of the CR programs has been inadequate attention paid to an important clinical observation: not all patients show the same magnitude of improvement during CR, and some patients may even get worse.
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