Just 55% of countries offer cardiac rehab, leaving 18M patients without access

Only half of the world’s countries offer cardiac rehabilitation programs, according to a recent survey, leaving some 18 million heart patients across the globe without access to therapy that could vastly improve their prognosis and quality of life.

That means that, of the more than 20 million people who develop heart disease globally each year, just 1 in 12 would be able to secure a spot in a cardiac rehab program, lead investigator Sherry Grace, a professor at York University in Toronto, said in a release. The programs that do currently exist—ones that cut patients’ chances of CV death and rehospitalization by as much as 20%—can only serve 1.65 million patients.

“Almost half of countries around the globe have absolutely no cardiac rehab,” Grace said. “People are dying unnecessarily without these programs.”

Grace and her colleagues published their recent findings in EClinicalMedicine, where they reported the results of both a survey and global audit they’d completed through the International Council of Cardiovascular Prevention and Rehabilitation. A team of 58 investigators established the baseline facts: cardiac rehab programs were available in 55% of the world’s 200 countries, and they’re largely underutilized.

The researchers reached out to the nearly 6,000 active programs worldwide with a survey, receiving responses from 93 of the 111 countries involved. They said programs reported treating fewer patients than expected each year, mostly due to a lack of resources.

Grace et al.’s results pointed to Africa and Southeast Asia as the regions with the greatest need for cardiac rehab; India, China and Russia all seemingly needed “millions” more openings in rehab programs to accommodate the growing number of patients in their countries with CVD. But even in Canada, which consistently ranks among the best in the world for program capacity, there’s only one cardiac rehab spot available for every 4.5 heart attack patients.

Where they are available, the team said cardiac rehab programs seemed to be of a high quality. Existing programs usually met international standards, staffed by an average of six employees and offering patients a mean 9 out of 11 recommended core components. Grace and colleagues said that, as was to be expected, components varied by region, and there was inconsistent delivery of tobacco cessation, stress management and return-to-work support programs.

Grace said it’s important to speak out in favor of more rehab programs backed by public healthcare systems or even private insurance companies.

“Increased capacity could also be achieved by delivering more unsupervised programs—for example by exploiting technology through home-based cardiac rehabilitation, which was offered in only 38 countries,” she said. “Delivery in these settings is just as effective at reducing death in heart patients.”