title: Cardiac Rehabilitation: Underrecognized/Underutilized.
abstract: Unfortunately, too many patients continue to rely on costly coronary revascularization procedures, cardioprotective medications, or both, as first-line strategies to stabilize the course of coronary heart disease. However, these palliative therapies do not address the foundational or most proximal risk factors for coronary disease, that is, unhealthy dietary habits, physical inactivity, and cigarette smoking. Because most acute myocardial infarctions evolve from mild-to-moderate coronary artery stenosis (<70 % obstruction), rather than at the more severe obstructions that are commonly treated with coronary revascularization, these findings help explain the inability to demonstrate a reduction in acute cardiac events in most studies examining coronary artery bypass graft surgery and/or percutaneous coronary interventions. The delivery of comprehensive cardiovascular risk reduction, including exercise-based cardiac rehabilitation as an integral component, offers patients a bona fide treatment intervention to prevent recurrent cardiovascular events and the need for repeated revascularization procedures, while simultaneously providing referring physicians with ongoing surveillance data to potentially enhance their medical management.
authors.affiliation: Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI, USA. Barry.Franklin@beaumont.org.|Internal Medicine and Biomedical Engineering, Oakland University William Beaumont School of Medicine, Rochester, MI, USA. Barry.Franklin@beaumont.org.|Beaumont Health Center, Cardiac Rehabilitation, 4949 Coolidge Highway, Royal Oak, MI, 48073, USA. Barry.Franklin@beaumont.org.
authors.forename: Barry A
authors.initials: BA
authors.lastname: Franklin
authors.affiliation: Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI, USA.|Beaumont Health Center, Cardiac Rehabilitation, 4949 Coolidge Highway, Royal Oak, MI, 48073, USA.
authors.forename: Jenna
authors.initials: J
authors.lastname: Brinks
keywords: Cardiac rehabilitation; Cardiorespiratory fitness; Cardiovascular mortality; Risk factor reduction; Secondary prevention; Structured exercise