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Getting patients with cardiovascular disease to move more: cardiac rehabilitation and beyond

Exercise is a vital medicine that every individual should be taking, from apparently healthy individuals to those diagnosed with one or more chronic conditions [1]. In fact, expanding on this paradigm, we are gaining an appreciation that all forms of physical movement are medicine [2,3]. For those diagnosed with cardiovascular disease (CVD), cardiac rehabilitation (CR) is considered a standard of care [4]. While CR is a multifactorial healthy living (HL) intervention, supervised exercise training, and preparing patients to manage their training program independently are central components. Although CR is strongly endorsed by leading professional organizations [5], patient participation continues to be unacceptably low [5,6], particularly in those who would benefit most from HL medicine (HLM) [7]. This editorial will address the following: (1) Rethinking health professions training to include HLM as an integral curricular component; (2) key factors to consider in facilitating greater participation in CR; (3) the importance of improving cardiorespiratory fitness (CRF) with exercise training; and (4) the importance of getting all patients with CVD to move more independent of CR attendance.