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Getting into cardiac rehab

What cardiac rehab is, who MedlinePlus says it is for, what one review of trials found, how many eligible Medicare patients took part in one study, and questions to ask a care team.

What cardiac rehab is

  • Cardiac rehabilitation, called rehab for short, is a medically supervised program.1
  • MedlinePlus gives its goal as helping people return to an active life and lowering the chance of further heart problems.2
  • A team of specialists creates the plan.3
  • The program also teaches how to lower risk factors such as high blood pressure, high blood cholesterol, depression and diabetes.4

Who MedlinePlus says rehab is for

  • MedlinePlus says rehab is a program to help people who have had a heart attack, angioplasty or bypass surgery for coronary heart disease, or heart valve repair or replacement.5
  • MedlinePlus also names a heart or lung transplant, angina and heart failure.6

What one review of rehab trials found

  • A Cochrane review combined 85 trials of exercise-based rehab with 23,430 people who had coronary heart disease.7
  • Most of the people in these trials had a heart attack or a procedure to restore blood flow to the heart.7, 8
  • Women made up fewer than 15% of the people in these trials.9
  • At 6 to 12 months, the review found fewer heart attacks with rehab than with no exercise, and rated this result high certainty.7
  • At 6 to 12 months, it also found, with moderate certainty, that rehab likely lowers hospital admissions for any cause by a large amount.10
  • At 6 to 12 months, it found, with moderate certainty, a likely slight drop in deaths from any cause, but the range of possible results included no effect.10
  • At 6 to 12 months, the review found, with moderate certainty, that rehab likely made little to no difference in deaths from heart and blood vessel causes.10
  • At 6 to 12 months, it was unsure about the effect on hospital admissions for heart and blood vessel problems, a result it rated low certainty.11
  • From more than 12 to 36 months, the review said there may be little to no difference in deaths from any cause, heart attacks and hospital admissions for any cause, but it found a large drop in deaths from heart and blood vessel causes.12
  • After more than 3 years, the review said rehab may make little to no difference in deaths from any cause but may lower deaths from heart and blood vessel causes and heart attacks by a large amount, results it did not rate for certainty.12

Taking part in rehab: a 2016 Medicare study

  • A study of Medicare records found that 24.4% of people in traditional (fee-for-service) Medicare who were eligible for rehab in 2016 attended at least one session.13
  • Of those who took part, 26.9% completed rehab, which the study defined as attending 36 or more sessions.13
  • In that study, participation was lower among women (18.9%) than among men (28.6%).13
  • In that study, participation was lower among Hispanic people (13.2%) and non-Hispanic Black people (13.6%) than among non-Hispanic white people (25.8%).13
  • In that study, participation ranged from 7.1% after a heart attack hospital stay without a procedure to 55.3% after bypass surgery alone.13
  • A Million Hearts road map set a goal of raising participation to 70% or more by 2022.13

What hospitals can do to raise use

  • A Million Hearts toolkit for cardiac rehab aims to help hospital and rehab teams improve care for more eligible patients.14
  • Its second edition, published in 2023, adds new content on referring patients to rehab automatically unless they decline, with help to coordinate their care.15, 16

Parts of a rehab plan, as MedlinePlus lists them

  • The plan includes exercise training.3
  • The plan includes education on heart healthy living.3
  • The plan includes counseling to reduce stress.3

Questions to ask

  1. Is my heart condition or procedure one of those the sources list for rehab?
  2. If nobody has mentioned rehab, can my care team say whether I qualify and how to get a referral?
  3. Does this hospital refer eligible patients to rehab automatically?
  4. What would my own rehab plan include, and who would be on the team?
  5. How many sessions make up a full program here?
  6. Does the review of rehab trials include people with my kind of heart condition?

Sources

  1. Cardiac Rehabilitation (MedlinePlus health topic) Webpage, U.S. National Library of Medicine (MedlinePlus), Summary, para 1. Retrieved .
  2. Cardiac Rehabilitation (MedlinePlus health topic) Webpage, U.S. National Library of Medicine (MedlinePlus), Summary, para 2, sentence 1. Retrieved .
  3. Cardiac Rehabilitation (MedlinePlus health topic) Webpage, U.S. National Library of Medicine (MedlinePlus), Summary, para 2, sentence 2. Retrieved .
  4. Cardiac Rehabilitation (MedlinePlus health topic) Webpage, U.S. National Library of Medicine (MedlinePlus), Summary, para 2, sentence 3. Retrieved .
  5. Cardiac Rehabilitation (MedlinePlus health topic) Webpage, U.S. National Library of Medicine (MedlinePlus), Summary, para 1 and list items 1 to 3. Retrieved .
  6. Cardiac Rehabilitation (MedlinePlus health topic) Webpage, U.S. National Library of Medicine (MedlinePlus), Summary, para 1 and list items 4 to 6. Retrieved .

  7. An updated Cochrane review of 85 randomised trials, which together randomised 23,430 people with coronary heart disease, compared exercise-based cardiac rehabilitation with a no-exercise control. At short-term follow-up (6 to 12 months) it found a large reduction in myocardial infarction (risk ratio 0.72, 95% CI 0.55 to 0.93; 22 trials; number needed to treat for an additional beneficial outcome 75, 95% CI 47 to 298), rated high certainty. It found little to no difference in coronary artery bypass graft (risk ratio 0.99, 95% CI 0.78 to 1.27; 20 trials), also rated high certainty.

    Applies to Adult
    • Adult men and women who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris or coronary artery disease, in trials that compared exercise-based cardiac rehabilitation with a no-exercise control. The 85 trials included predominantly post-MI and post-revascularisation patients.
    • Randomised trials of exercise-based cardiac rehabilitation, with exercise training alone or combined with psychosocial or educational interventions. The abstract does not describe the settings of the individual trials.
    • Trials from many countries; the abstract says 21 of the 85 trials were done in low- and middle-income countries.
    • Adults; the mean age across the included trials ranged from 47 to 77 years
    Follow-up The review split results into short-term (6 to 12 months), medium-term (more than 12 to 36 months) and long-term (more than 3 years) follow-up. The median longest follow-up was 12 months (range 6 months to 19 years).

    Limitations. Adults with coronary heart disease in trials of exercise-based cardiac rehabilitation (exercise training alone or with psychosocial or educational interventions) against a no-exercise control. The trials were predominantly post-MI and post-revascularisation patients, and women were under 15% of participants overall. Trial reporting was poor overall, although the abstract says reporting quality improved over the last decade. Only the PubMed abstract was read; the PMC copy is not in the open-access subset. The review gives GRADE ratings only for the primary outcomes at 6 to 12 months; moderate and low certainty outcomes are on separate claims.

  8. Exercise-based cardiac rehabilitation for coronary heart disease Publication, The Cochrane database of systematic reviews, Abstract, DATA COLLECTION AND ANALYSIS, sentence 6. Retrieved .
  9. Exercise-based cardiac rehabilitation for coronary heart disease Publication, The Cochrane database of systematic reviews, Abstract, DATA COLLECTION AND ANALYSIS, sentence 7. Retrieved .

  10. At the same short-term follow-up (6 to 12 months), the Cochrane review reports with moderate certainty that exercise-based cardiac rehabilitation likely results in a slight reduction in all-cause mortality (risk ratio 0.87, 95% CI 0.73 to 1.04; 25 trials; the interval includes 1) and a large reduction in all-cause hospitalisation (risk ratio 0.58, 95% CI 0.43 to 0.77; 14 trials; number needed to treat for an additional beneficial outcome 12, 95% CI 9 to 21). It reports that exercise-based cardiac rehabilitation likely results in little to no difference in cardiovascular mortality (risk ratio 0.88, 95% CI 0.68 to 1.14; 15 trials) and in percutaneous coronary intervention (risk ratio 0.86, 95% CI 0.63 to 1.19; 13 trials).

    Applies to Adult
    • Adult men and women who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris or coronary artery disease, in trials that compared exercise-based cardiac rehabilitation with a no-exercise control. The 85 trials included predominantly post-MI and post-revascularisation patients.
    • Randomised trials of exercise-based cardiac rehabilitation, with exercise training alone or combined with psychosocial or educational interventions. The abstract does not describe the settings of the individual trials.
    • Trials from many countries; the abstract says 21 of the 85 trials were done in low- and middle-income countries.
    • Adults; the mean age across the included trials ranged from 47 to 77 years
    Follow-up The review split results into short-term (6 to 12 months), medium-term (more than 12 to 36 months) and long-term (more than 3 years) follow-up. The median longest follow-up was 12 months (range 6 months to 19 years).

    Limitations. Adults with coronary heart disease in trials of exercise-based cardiac rehabilitation (exercise training alone or with psychosocial or educational interventions) against a no-exercise control. The trials were predominantly post-MI and post-revascularisation patients, and women were under 15% of participants overall. Trial reporting was poor overall, although the abstract says reporting quality improved over the last decade. Only the PubMed abstract was read; the PMC copy is not in the open-access subset. The abstract notes small study bias for all-cause hospitalisation. The all-cause mortality result is reported as a likely slight reduction, but its confidence interval includes no effect.

  11. The Cochrane review is uncertain about the effect of exercise-based cardiac rehabilitation on cardiovascular hospitalisation at 6 to 12 months: the risk ratio was 0.80 (95% CI 0.41 to 1.59), with a wide interval that includes considerable benefit as well as harm, rated low certainty. The abstract also reports substantial heterogeneity across trials for cardiovascular hospitalisations (I2 = 53%).

    Applies to Adult
    • Adult men and women who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris or coronary artery disease, in trials that compared exercise-based cardiac rehabilitation with a no-exercise control. The 85 trials included predominantly post-MI and post-revascularisation patients.
    • Randomised trials of exercise-based cardiac rehabilitation, with exercise training alone or combined with psychosocial or educational interventions. The abstract does not describe the settings of the individual trials.
    • Trials from many countries; the abstract says 21 of the 85 trials were done in low- and middle-income countries.
    • Adults; the mean age across the included trials ranged from 47 to 77 years
    Follow-up The review split results into short-term (6 to 12 months), medium-term (more than 12 to 36 months) and long-term (more than 3 years) follow-up. The median longest follow-up was 12 months (range 6 months to 19 years).

    Limitations. Adults with coronary heart disease in trials of exercise-based cardiac rehabilitation (exercise training alone or with psychosocial or educational interventions) against a no-exercise control. The trials were predominantly post-MI and post-revascularisation patients, and women were under 15% of participants overall. Trial reporting was poor overall, although the abstract says reporting quality improved over the last decade. Only the PubMed abstract was read; the PMC copy is not in the open-access subset. This is a result the review itself calls uncertain, so it does not show that the programmes help or harm on this outcome.

  12. The Cochrane review also reports longer follow-up results. At medium-term follow-up (more than 12 to 36 months) there may be little to no difference in all-cause mortality (risk ratio 0.90, 95% CI 0.80 to 1.02; 15 trials), myocardial infarction (1.07, 0.91 to 1.27; 12 trials), percutaneous coronary intervention (0.96, 0.69 to 1.35; 6 trials), coronary artery bypass graft (0.97, 0.77 to 1.23; 9 trials) and all-cause hospitalisation (0.92, 0.82 to 1.03; 9 trials), but a large reduction in cardiovascular mortality was found (0.77, 0.63 to 0.93; 5 trials); the evidence is uncertain for cardiovascular hospitalisation (0.92, 0.76 to 1.12; 3 trials). At long-term follow-up (more than 3 years) there may be little to no difference in all-cause mortality (0.91, 0.75 to 1.10), while exercise-based cardiac rehabilitation may result in a large reduction in cardiovascular mortality (0.58, 0.43 to 0.78; 8 trials) and myocardial infarction (0.67, 0.50 to 0.90; 10 trials); the evidence is uncertain for coronary artery bypass graft (0.66, 0.34 to 1.27; 4 trials) and percutaneous coronary intervention (0.76, 0.48 to 1.20; 3 trials). Each value is a risk ratio with its 95% confidence interval.

    Applies to Adult
    • Adult men and women who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris or coronary artery disease, in trials that compared exercise-based cardiac rehabilitation with a no-exercise control. The 85 trials included predominantly post-MI and post-revascularisation patients.
    • Randomised trials of exercise-based cardiac rehabilitation, with exercise training alone or combined with psychosocial or educational interventions. The abstract does not describe the settings of the individual trials.
    • Trials from many countries; the abstract says 21 of the 85 trials were done in low- and middle-income countries.
    • Adults; the mean age across the included trials ranged from 47 to 77 years
    Follow-up The review split results into short-term (6 to 12 months), medium-term (more than 12 to 36 months) and long-term (more than 3 years) follow-up. The median longest follow-up was 12 months (range 6 months to 19 years).

    Limitations. Adults with coronary heart disease in trials of exercise-based cardiac rehabilitation (exercise training alone or with psychosocial or educational interventions) against a no-exercise control. The trials were predominantly post-MI and post-revascularisation patients, and women were under 15% of participants overall. Trial reporting was poor overall, although the abstract says reporting quality improved over the last decade. Only the PubMed abstract was read; the PMC copy is not in the open-access subset. The review used GRADE only for the primary outcomes at 6 to 12 months, so these medium- and long-term results carry no certainty rating in the abstract. The abstract gives the number of trials behind each result.

  13. In an observational study of Medicare fee-for-service beneficiaries who were eligible for cardiac rehabilitation in 2016, 89,327 of 366,103 (24.4%) participated (attended at least 1 session), assessed through 2017. Of those who participated, 24.3% started within 21 days of the qualifying event and 26.9% completed rehabilitation (36 or more sessions attended). Participation was lower among women (18.9%) than men (28.6%), and lower among Hispanic (13.2%) and non-Hispanic Black (13.6%) beneficiaries than non-Hispanic white beneficiaries (25.8%). It varied by region, from 18.6% (East South Central Census Division) to 39.1% (West North Central), and by qualifying event, from 7.1% (acute myocardial infarction without procedure) to 55.3% (coronary artery bypass surgery only). The Million Hearts Cardiac Rehabilitation Collaborative set a road map goal of raising participation rates to 70% or more by 2022.

    Applies to Adult
    • Medicare fee-for-service beneficiaries who were eligible for cardiac rehabilitation in 2016 (366,103 people), identified through a qualifying event: acute myocardial infarction hospitalization, coronary artery bypass surgery, heart valve repair or replacement, percutaneous coronary intervention, or heart or heart-lung transplant.
    • Medicare fee-for-service claims in the United States.
    • United States; results are also given by Census Division and hospital referral region.
    • Adults; participation decreased with increasing age (abstract). The abstract gives no age range.
    Follow-up Participation, timely initiation and completion were assessed through 2017.

    Limitations. Medicare fee-for-service beneficiaries only, so the figures do not describe people with other coverage. Participation means attending at least one session. The study is observational and uses claims, and the abstract gives no reasons for non-participation. It covers a 2016 eligible group followed through 2017; this record has not looked for later data, and the 2022 goal date has passed. The AACVPR, AHA and ACC scientific statement separately describes the use of cardiac rehabilitation in the United States as significantly underused.

  14. Cardiac Rehabilitation Change Package (Second Edition) (Million Hearts) Webpage, Centers for Disease Control and Prevention (Million Hearts), What Is the CRCP, para 5. Retrieved .
  15. Cardiac Rehabilitation Change Package (Second Edition) (Million Hearts) Webpage, Centers for Disease Control and Prevention (Million Hearts), What Is the CRCP, para 6, sentence 2. Retrieved .
  16. Cardiac Rehabilitation Change Package (Second Edition) (Million Hearts) Webpage, Centers for Disease Control and Prevention (Million Hearts), What Is the CRCP, para 6, bullet 4. Retrieved .

About this guide

Written for
Adults with a heart condition or a recent heart event, and the people with them
What it covers
Written from a US government health page, a review of trials, a study of Medicare records and a toolkit for hospitals. It describes what these sources say and gives no advice for one person.
Pages it explains
Sources checked
2026-10-15
Next check due
2027-04-15
Reading level
Estimated grade 8.7 (target 9)

Every sentence cites a source. Words in quotation marks are the source's own; the rest is the atlas's summary.

https://cardio.openmedicalatlas.org/guides/getting-into-cardiac-rehab/ · Release 73130c34862e2d06, built 2026-10-15