If we want to future-proof cardiac care in Australia, we need to rethink the country’s approach to secondary prevention through cardiac rehabilitation.
Over the past 60 years, Australia has made remarkable progress in cardiovascular health. Thanks to advances in acute care, prevention, and public health policy, mortality rates from heart disease have decreased by more than 75% (here and here).
However, this success has created new and escalating challenges, with the number of Australians living with heart disease requiring long-term preventive and tailored support. By 2050, predicted The number of people living with heart disease and its sequelae around the world will increase tenfold.
Approximately 500,000 Australians are admitted to hospital with heart disease each year. Survivors are 10 times more likely to have a future heart attack, with 40% being readmitted to the hospital and 20% dying within three years. The impact on people’s lives is immeasurable, and the economic cost exceeds $14 billion each year and continues to rise.here and here).
reconsider the concept of cardiac rehabilitation We need it to future-proof our cardiac care system.
Rehabilitation: A proven but underutilized foundation
For the past 60 years, cardiac rehabilitation has been the cornerstone of recovery after heart attacks, cardiac surgeries, and other cardiac events. These programs typically run over six to eight weeks and have provided supervised exercise, education, and psychological support to people in the acute phase following diagnosis or treatment. Such programs have been carried out before. proven It reduces recurrent events and hospitalizations, improves quality of life, and helps people return to work and community life.
Despite these benefits, cardiac rehabilitation programs have not kept pace with societal changes and medical advances. program remains underutilizedare underfunded and access is unevenly distributed. less than half Only a small percentage of eligible patients have ever been referred. Every year, more than 375,000 Australians miss out on this critical recovery stage.
The term itself is a challenge because, although well accepted, the term “cardiac rehabilitation” focuses solely on “cardiac” diagnosis (as opposed to broader cardiovascular disease) and implies the need to “rehabilitate” individuals for a limited period of recovery rather than promoting lifelong cardiovascular health or reducing the risk of new events. Global efforts Improving access and system efficiency is needed to improve quality, evaluate new models of care, and enhance lifelong health for people living with heart disease.
Ross’s story: rebuilding life after heart disease
In 2025, the World Heart Federation, in collaboration with BBC StoryWorks, “Beat of Change” The series includes Ross’ post-diagnosis story. Mr Ross, a train driver from the Gold Coast, told of his journey to recovery. After undergoing heart surgery, he received minimal follow-up after being discharged from the hospital and sought support on his own to regain confidence and hope. His story reflects the growing number of Australians who are missing out on vital care and support.
What started as a personal recovery turned into something much bigger. Ross currently facilitates peer support sessions for others living with heart disease, helping them navigate the physical and emotional challenges of life after a cardiac event. His story is a reminder that recovery is about more than just exercise and short-term education. It’s about restoring purpose and connection. In Ross’ own words in the mini-documentary, he feels that “the most important thing for anyone recovering from heart disease is to talk to people who understand the condition and offer encouragement to keep going.”
SOLVE-CHD: Rethinking rehabilitation through research
in Solve-CHDpowered by a National Health and Medical Research Council (NHMRC) Synergy grant, we are working to bridge the gap between evidence and access. Our multidisciplinary team brings together researchers, clinicians, public health experts, and people with real-world experience to redesign the way rehabilitation is delivered, making it more personalized, digital, and equitable.
One such project is heart 2 hearts A clinical trial evaluating a digital peer support application that connects people with heart disease wherever they are. This is a simple but powerful idea. It uses technology and real-world experience to provide empathy, encouragement, and continuity of care beyond the hospital walls.
SOLVE-CHD’s broad mission is to ensure that cardiac rehabilitation becomes a consistently accessible and integral part of cardiac care, rather than an afterthought. This national initiative aims to strengthen service delivery across Australia and enable clinicians to deliver best practice care by generating national data, quality benchmarks and implementation tools.
collective call to action
If we want to future-proof cardiac care in Australia, we need to rethink our national approach to secondary prevention. Our team is working with the World Heart Federation to create a new roadmap that outlines a pathway to lifelong cardiovascular health that all countries can implement.
Inequalities remain a challenge, and a one-size-fits-all approach to achieving different quality standards contributes to the underrepresentation of diverse groups. Clinicians and policy makers have a critical role in referring patients, advocating for program expansion, and recognizing that post-discharge care and long-term risk reduction are essential. Researchers and policy makers must continue to listen to those with lived experience to improve reach, quality of care, productivity, and system efficiency.
Australia has an opportunity to lead again by ensuring all Australians recover well and live fully after a heart attack. Through our collective efforts, it is time to listen, invest, and act to ensure that people like Ross receive all the care and support they need to live their best lives.
Julie Redfern is a clinical researcher, Director of the Institute for Evidence-Based Healthcare, Professor of Public Health at Bond University, and Adjunct Professor in the School of Medicine and Health at the University of Sydney. She leads a world-leading health services research program in preventive cardiology.
Robin Gallagher is an academic nursing researcher and academic director of the University of Sydney’s Northern Branch. She leads a world-class research group that develops and tests cardiac rehabilitation and service delivery interventions.
Tom Biffa is a cardiovascular health researcher and professor of public health in the School of Population and Global Health at the University of Western Australia. He has an established research career in the areas of cardiovascular epidemiology, care models, clinical trials, and registries built on data linkage.
Dion Candelaria is a clinician and researcher and an emerging leader in health services research and cardiovascular nursing. He is currently a Heart Foundation Postdoctoral Fellow at the University of Sydney and President-elect of the Australian Cardiovascular Health and Rehabilitation Association.
JR is funded by NHMRC Investigator Grant L2. [GNT2007946]DC receives funding from a National Heart Foundation Postdoctoral Fellowship. SOLVE-CHD is funded by an NHMRC Synergy Grant [GNT1182301].