Cardiac rehabilitation led to a 28% relative reduction in heart attacks, according to a review of 107 randomized controlled trials involving 26,886 people with coronary heart disease. The review assessed whether exercise-based cardiac rehabilitation improved outcomes compared with no structured exercise. Beyond lowering the relative risk of heart attacks, it also reduced all-cause hospital admissions by around 35%. Within 6 to 12 months, one heart attack was prevented for every 71 people who participated, a number needed to treat (NNT) of 71 that experts describe as a massive return on investment.

The importance of exercise-based rehabilitation for heart health cannot be overstated. As Dr. Rigved Tadwalkar explained, achieving an NNT in the 70s in less than a single year proves that structured movement is a highly potent primary medical therapy. For patients recovering from a heart attack, participating in rehab is just as critical to survival as daily medications. Aerobic exercise is the bedrock of cardiac recovery, directly improving endothelial function and building cardiovascular endurance. Common exercises include aerobic exercise, static cycling, walking and circuit training. Strength training, though historically underutilized, is increasingly recognized as vital for long-term longevity, metabolic health and daily functioning, especially for older adults.

A major advantage of cardiac rehabilitation is its flexibility. Home-based and digital exercise programs have been shown to be as effective as traditional in-person rehabilitation, offering increased accessibility for those unable to attend hospital sessions. As Tadwalkar noted, leveraging smartwatches, remote coaching and continuous digital monitoring allows clinicians to deliver world-class care to patients who might otherwise fall through the cracks. Appropriately prescribed exercise is safe for most patients after the acute phase has been resolved and stability confirmed, though starting with professional evaluation and progressing gradually under clinical guidance is key.

In conclusion, exercise-based cardiac rehabilitation is an inexpensive, cost-effective and underprioritized intervention that significantly reduces heart attack risk and hospital admissions. Given its proven benefits, we should strongly advocate for making cardiac rehab a routine part of care for every eligible patient with coronary heart disease. Healthcare systems, clinicians and policymakers must prioritize funding and referral to these programs, while patients should be encouraged to embrace them as a powerful, potentially lifesaving therapy. With digital and hybrid models expanding access, there has never been a better time to bring cardiac rehabilitation to a vastly wider population.