An Ounce of Prevention and a Pound of Cardiac Rehabilitation

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality globally, underscoring the need for comprehensive prevention and rehabilitation strategies. Cardiovascular rehabilitation (CR) programs are multidisciplinary, addressing risk factor management, physical activity (PA), smoking cessation, psychosocial care, and nutritional counselling to support recovery, enhance quality of life (QoL), and reduce secondary CVD events. Over the previous several decades, CR has evolved from inpatient care in hospitals to community-based, home-based, and virtual models, driven by efforts to improve accessibility and equity. Research has advanced program design, including optimal duration, contact frequency, and referral strategies, while expanding preventive approaches to families and high-risk populations. Digital health technologies, including telehealth, wearable devices, and AI-enabled tools, are increasingly integrated to personalize care and extend reach. Innovations in exercise delivery such as high-intensity interval training, Nordic walking, and strength training aim to enhance engagement and physical and mental health outcomes. Smoking cessation interventions such as the Ottawa Model for Smoking Cessation improve patient outcomes and reduce recurrent CVD events. Psychosocial care, delivered through stepped-care models and interventions such as cognitive behavioral therapy and stress management, enhances mental health and adherence. Established dietary patterns, including Mediterranean and DASH diets, are complemented by innovative approaches such as time-restricted eating and pharmacotherapy to support weight management and cardiovascular health. Collectively, these advancements reflect a global shift toward personalized, inclusive, and technology-enabled care designed to reduce disparities, extend CR benefits to broader populations, and improve adherence to heart-healthy behaviours.