Cardiac rehabilitation in Europe.

Cardiovascular disease (CVD) remains the main cause of death for men in most European countries, and in all for women. While mortality rates have been declining in most countries, hospital discharge for CVD has been stable since 2004, increasing the pool of patients eligible for cardiac rehabilitation (CR). The physical rehabilitation of patients with CVD has been practiced in Europe to varying degrees since the early 1970s with most countries now engaged in Phase I through Phase III programs. Funding for CR comes from a variety of sources including patient pay, private insurance, retirement and/or obligatory and governmental subsidy. CR is practiced based on best available evidence but participation rates range between 30-50% of eligible patients. Participation rates present one of several challenges and opportunities for future research in Europe, along with assessment of long-term CR outcomes and better extension to primary prevention.