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If we are to future-proof heart care in Australia, we must reimagine our national commitment to secondary prevention through cardiac rehabilitation.
Over the past 60 years, Australia has made remarkable progress in cardiovascular health. Mortality from heart disease has fallen by more than 75%, thanks to advances in acute care, prevention, and public health policy (here and here).
But this success has created a new and escalating challenge — a growing number of Australians living with heart disease who need long-term preventative, coordinated support. By 2050, It is predicted there will be a 10-fold increase in the number of people living with heart disease and its sequelae world-wide.
Around 500 000 Australians are admitted to hospital with a heart condition every year. Survivors are at 10 times higher risk of future heart attacks, and within three years, 40% will be readmitted to hospital and 20% will die. The impact on people’s lives is immeasurable, and the financial cost exceeds $14 billion each year, and continues to grow (here and here).
Reimagining the concept of cardiac rehabilitation is needed to future-proof our cardiac care system.
Rehabilitation: a proven but underused cornerstone
For the past 60 years, cardiac rehabilitation has long been the cornerstone of recovery after a heart attack, heart procedure, or other cardiac event. Typically delivered over 6-8 weeks, these programs have traditionally delivered supervised exercise, education, and psychological support for people in the acute period after diagnosis or treatment. Such programs have been demonstrated to reduce recurrent events and hospitalisations, improve quality of life, and help people return to work and community life.
Despite these benefits, cardiac rehabilitation programs have not kept pace with societal changes and medical advancements. Programs remain underutilised, underfunded, and access is unevenly distributed. Less than half of eligible patients are ever referred, and only a fraction attend. Each year, more than 375,000 Australians miss out on this vital stage of recovery.
The terminology itself presents a challenge because although well accepted the term ‘cardiac rehabilitation’ implies a focus on only ‘cardiac’ diagnoses (as opposed to the broader cardiovascular conditions) and the need to ‘rehabilitate’ individuals for a finite period of recovery rather than promotion of lifelong cardiovascular health and lowering risk of new events. Global efforts are needed to improve quality, evaluate new models of care and strengthen lifelong health for people living with heart disease with improved access and system efficiency.
Ross’s story: rebuilding life after a heart event
In 2025, the World Heart Federation in collaboration with BBC StoryWorks produced the ‘Beats of Change’ Series that included Ross’ story after diagnosis. Ross, a train driver from the Gold Coast, shared his journey of recovery. After undergoing a heart procedure, he was offered minimal follow-up after discharge, and he sought support himself in pursuit of rebuilding his confidence and hope. His story reflects the growing number of Australians who miss out on important care and support.
What began as a personal recovery became something larger. Ross now 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 not just about exercise or short-term education; it is about restoring purpose and connection. In Ross’ own words in the mini-documentary he feels “the most important thing for a person recovering from heart disease is talking to people that understand the condition and the encouragement to keep moving forward”
SOLVE-CHD: reimagining rehabilitation through research
At SOLVE-CHD, a National Health and Medical Research Council (NHMRC) Synergy Grant, we are working to close the gap between evidence and access. Our multidisciplinary team brings together researchers, clinicians, public health professionals and people with lived experience to redesign the way rehabilitation is delivered — making it more personalised, digital and equitable.
One such project, the Heart2Heart clinical trial that is evaluating a digital peer support application that connects people living with heart disease, wherever they are. It is a simple but powerful idea: harnessing technology and lived experience to provide empathy, encouragement, and continuity of care beyond the hospital walls.
SOLVE-CHD’s broader mission is to ensure that cardiac rehabilitation becomes a consistent, accessible, and integral part of heart care, not an afterthought. By generating national data, quality benchmarks, and implementation tools, this national initiative aims to strengthen service delivery across Australia and empower clinicians to deliver best-practice care.
A collective call to action
If we are to future-proof heart care in Australia, we must reimagine our national commitment to secondary prevention. Our team are working with the World Heart Federation to produce a new Roadmap that outlines a pathway to lifelong cardiovascular health for all countries to implement.
Inequities remain a challenge where a one-size-fits-all approach with varied achievement of quality standards has contributed to diverse groups being under-represented. Clinicians and policymakers have a pivotal role to play, referring patients, advocating for program expansion, and recognising post-discharge care and lowering long-term risk as vital. Researchers and policymakers should continue to listen to those with lived experience as we improve reach, quality of care, productivity and system efficiency.
Australia has the opportunity to lead again by ensuring every Australian can recover well and live fully after a heart event. Through our collective effort, it is time to listen, invest and act, so that people like Ross receive all the care and support they need to enable them to live their best lives.
Julie Redfern is a clinician-researcher, Director of the Institute for Evidence-Based Healthcare and Professor of Public Health at Bond University and an Adjunct Professor in the Faculty of Medicine and Health at the University of Sydney. She leads a world-leading program of health services research in preventive cardiology.
Robyn Gallagher is an academic nurse researcher and Academic Director Northern Precinct at the University of Sydney. She leads a world-leading research group developing and testing cardiac rehabilitation and service delivery interventions.
Tom Birffa 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 cardiovascular epidemiology, models of care, clinical trials and registries built on data linkage.
Dion Candelaria is a clinician-researcher and an emerging leader in health services research and cardiovascular nursing. He is currently a Heart Foundation Postdoc Fellow at the University of Sydney and is President-Elect of the Australian Cardiovascular Health and Rehabilitation Association.
JR is funded by a NHMRC Investigator Grant L2 [GNT2007946], DC is funded by a National Heart Foundation Postdoctoral Fellowship. SOLVE-CHD is funded by a NHMRC Synergy Grant [GNT1182301].