Australia's Heart Care: Re-evaluating Cardiac Rehabilitation for Lifelong Health
The necessity of re-evaluating Australia's approach to cardiac rehabilitation is paramount to support a growing number of individuals living with heart disease. While Australia has reduced heart disease mortality by over 75% in the last 60 years, this success has led to an increasing population requiring long-term preventative care.
"While Australia has reduced heart disease mortality by over 75% in the last 60 years, this success has led to an increasing population requiring long-term preventative care."
Annually, approximately 500,000 Australians are hospitalized due to heart conditions. Survivors face a 10-fold increased risk of future heart attacks, with 40% readmitted within three years and 20% dying. The financial burden of heart disease in Australia exceeds $14 billion each year.
The Current State of Cardiac Rehabilitation
Cardiac rehabilitation has historically been a critical component of recovery after cardiac events, typically involving 6-8 week programs of supervised exercise, education, and psychological support. These programs have demonstrated effectiveness in reducing recurrent events, hospitalizations, and improving quality of life.
However, these vital programs are currently underutilized, underfunded, and inconsistently accessible. Less than half of eligible patients are referred, and only a fraction participate, leaving over 375,000 Australians annually without this essential support. The term "cardiac rehabilitation" itself may be limiting, suggesting a focus on acute recovery rather than lifelong cardiovascular health.
"Less than half of eligible patients are referred, and only a fraction participate, leaving over 375,000 Australians annually without this support."
Initiatives and Future Directions
The SOLVE-CHD initiative, funded by a National Health and Medical Research Council (NHMRC) Synergy Grant, is actively working to bridge the gap between evidence and access in cardiac rehabilitation. This multidisciplinary team aims to redesign rehabilitation to be more personalized, digital, and equitable.
One significant project, the Heart2Heart clinical trial, evaluates a digital peer support application designed to connect individuals living with heart disease. This initiative leverages technology and lived experience to offer ongoing empathy, encouragement, and care beyond hospital settings. SOLVE-CHD's broader objective is to integrate cardiac rehabilitation as a consistent and accessible part of heart care across Australia by developing national data, quality benchmarks, and implementation tools.
A National Call to Action for Lifelong Heart Health
To prepare Australia's heart care system for the future, a renewed national commitment to secondary prevention is advocated. A new Roadmap, developed in collaboration with the World Heart Federation, aims to outline a clear path to lifelong cardiovascular health.
Addressing inequities in access and quality standards is crucial, with a call for clinicians and policymakers to support program expansion and recognize post-discharge care as vital. Researchers and policymakers are encouraged to incorporate the experiences of those living with heart disease to improve the reach and quality of care. Australia has an unparalleled opportunity to set a global standard in ensuring comprehensive recovery and full lives for all individuals after a heart event.
"Australia has an opportunity to set a global standard in ensuring comprehensive recovery and full lives for all individuals after a heart event."