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Eur J Prev Cardiol. 2014 Jun;21(6):664-81. doi: 10.1177/2047487312449597. Epub 2012 Jun 20.

Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology.

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Cardiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy Fondazione Toscana Gabriele Monasterio, Pisa, Italy
Department of Cardiology, Fondazione Salvatore Maugeri, IRCCS Scientific Institute of Veruno, Veruno, Italy.
Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece.
Department of Interventional Cardiology, Academic Hospital, Feldkirch, Austria.
Institute for Cardiology and Sports Medicine, German Sport University, Cologne, Germany.
Department of General Practice, Centre of Excellence for Public Health, Queen's University, Belfast, UK.
Jessa Hospital and University of Hasselt, Hasselt, Belgium.
Faculty of Health Sciences, York St John University, UK.
Departamentul de Cardiologie, Universitatea de Medicina si Farmacie 'Victor Babes' din Timisoara, Romania.
Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria.
Royal College of Surgeons in Ireland, Dublin, Ireland.
Cardiology Department, CHLO-Hospital de Santa Cruz, Carnaxide, Portugal.
Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.
National Research Centre for Preventive Medicine, Moscow, Russian Federation.
Hospital Universitario de León, Spain.
ZAR - Centre for Ambulatory Cardiovascular Rehabilitation at the Heart Centre Ludwigshafen, Germany.
Cardiovascular Prevention and Rehabilitation, Department of Cardiology, Bern University Hospital, and University of Bern, Switzerland.


Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorly implemented in clinical practice, often only on selected populations and over a limited period of time. The development of systematic and full comprehensive preventive programmes is warranted, integrated in the organization of national health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity. Cardiology and secondary prevention, including cardiac rehabilitation, have evolved almost independently of each other and although each makes a unique contribution it is now time to join forces under the banner of preventive cardiology and create a comprehensive model that optimizes long term outcomes for patients and reduces the future burden on health care services. These are the aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen to promote secondary preventive cardiology in clinical practice.


Cardiac prevention; cardiac rehabilitation; health care policy; high risk population

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