Availability, Density, and Unmet Need for Cardiac Rehabilitation Around the World

Abstract

Cardiovascular diseases are the leading cause of death worldwide, with 80% of these deaths occurring in low- and middle-income countries. Robust evidence, including randomized trials from these lower-resource countries, shows that cardiovascular rehabilitation (CR) substantially reduces mortality as well as morbidity. However, the avail ability and density of CR are insufficient and less so than other proven secondary prevention strategies. We can use such information to support CR development and expan sion efforts where they are needed most. Indeed, the International Council of Cardiovascular Preven tion and Rehabilitation (ICCPR: https://globalcardiacrehab. com/Global-CR-Program-Survey) undertook a first-ever global audit of CR around the world in 2016/2017 and did a rapid update in 2020, given the COVID-19 pandem ic Information on availability (ie, whether a country has any CR), density (ie, annual cardiac disease incidence esti mate from Global Burden of Disease study [https://www. healthdata.org/ghd/2019) divided by CR capacity (number of programs multiplied by median annual patient capacity per year]), and unmet need (ie, cardiac disease incidence minus capacity) each give us different but important infor mation on CR need.