Engaging Patients in Lifestyle Behaviour Change in Cardiovascular Secondary Prevention: Understanding the Complexity

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. Though total mortality rates for coronary artery disease have decreased significantly in the last three decades where there is access to modern therapeutics, at the same time, multiple risk factors such as obesity, diabetes mellitus and depression and anxiety have increased substantially [1]. Cardiovascular prevention and rehabilitation are therefore paramount and should be offered to all clinically eligible patients with CVD. Evidence-based cardiac rehabilitation (CR) provides a coordinated program of exercise, health education, cardiovascular risk reduction and psychosocial support [2]. As referral for CR is a Class 1a recommendation in international and national guidelines, these secondary prevention programs aim to eliminate or minimise the impact of cardiovascular mortality, and to prevent recurrent cardiac events and consequent hospital admissions