Exercise-Based Cardiac Rehabilitation Improves Outcomes in Coronary Heart Disease

A 2026 Cochrane systematic review and meta-analysis of 107 randomized trials involving 26,886 adults with coronary heart disease (CHD) found that exercise-based cardiac rehabilitation (CR), compared with no structured exercise, reduces myocardial infarction (MI) and all-cause hospitalizations, likely provides a small reduction in mortality, and improves health-related quality of life (HRQoL). In the short term (6–12 months), CR was associated with a 14% lower risk of all-cause mortality (RR 0.86), a possible 13% lower cardiovascular mortality (RR 0.87), and a 28% lower risk of MI (RR 0.72). It also reduced all-cause hospital admissions by 35% (RR 0.65), while having little or no effect on coronary artery bypass graft or percutaneous coronary intervention. Meaningful improvements in HRQoL were observed across multiple SF-36 domains and EQ-5D scores through 12 months, and eight economic evaluations consistently found exercise-based CR to be cost-effective in terms of quality-adjusted life years gained. Longer-term follow-up also showed associations with lower cardiovascular mortality and MI. Most participants were post-MI or post-revascularization, and although 78% of trials included women, women accounted for only 17% of participants overall. Recent studies increasingly evaluated home- and digitally supported CR and included participants from low- and middle-income countries, improving the global applicability of the evidence. Overall, the review supports exercise-based CR as an effective and cost-effective component of care for adults with CHD. Source: https://www.cochranelibrary.com/