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Heart. 2019 Apr;105(7):510-515. doi: 10.1136/heartjnl-2018-314206. Epub 2019 Jan 30.

Standards and core components for cardiovascular disease prevention and rehabilitation.

Author information

Cardiac Rehabilitation Lister Centre, University Hospital Crosshouse, Scotland, UK.
Centre for Active Living, University Centre Shrewsbury, Shrewsbury, UK.
Department of Health Sciences, University of York, York, UK.
Health and Life Sciences, Coventry University, Coventry, UK.
Cardiac Rehabilitation, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
British Association for Cardiovascular Prevention and Rehabilitation, London, UK.
Physiotherapy, Brunel University London, London, UK.
Health Psychology Service, ABM University Health Board, Princess of Wales Hospital, Bridgend, UK.
Institute of Health Research, University of Exeter Medical School, Exeter, UK.
Cardiology, Liverpool Heart and Chest NHS Foundation Trust, Liverpool, UK.


In 2017, the British Association for Cardiovascular Prevention and Rehabilitation published its official document detailing standards and core components for cardiovascular prevention and rehabilitation. Building on the success of previous editions of this document (published in 2007 and 2012), the 2017 update aims to further emphasise to commissioners, clinicians, politicians and the public the importance of robust, quality indicators of cardiac rehabilitation (CR) service delivery. Otherwise, its overall aim remains consistent with the previous publications-to provide a precedent on which all effective cardiovascular prevention and rehabilitation programmes are based and a framework for use in assessment of variation in service delivery quality. In this 2017 edition, the previously described seven standards and core components have both been revised to six, with a greater focus on measurable clinical outcomes, audit and certification. The principles within the updated document underpin the six-stage pathway of care for CR, and reflect the extensive evidence base now available within the field. To help improve current services, close collaboration between commissioners and CR providers is advocated, with use of the CR costing tool in financial planning of programmes. The document specifies how quality assurance can be facilitated through local audit, and advocates routine upload of individual-level data to the annual British Heart Foundation National Audit of Cardiac Rehabilitation, and application for national certification ensuring attainment of a minimum quality standard. Although developed for the UK, these standards and core components may be applicable to other countries.


cardiac rehabilitation; cardiac risk factors and prevention

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