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With increasing numbers of people living longer with symptomatic disease, the effectiveness and accessibility of secondary preventative and rehabilitative health services have never been more important. Whilst LMICs experience the highest prevalence and mortality rates, the global approach to secondary prevention and cardiac rehabilitation, which mitigates this burden, has traditionally been driven from clinical guidelines emanating from high-income settings. This state-of-the art review provides a contemporary global perspective on cardiac rehabilitation and secondary prevention, contrasting the challenges of and opportunities for high vs. lower income settings. Actionable solutions to overcome system, clinician, programme, and patient level barriers to cardiac rehabilitation access in LMICs are provided.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad225","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T22:04:56Z","timestamp":1680213896000},"page":"2515-2525","source":"Crossref","is-referenced-by-count":91,"title":["Global perspectives on heart disease rehabilitation and secondary prevention: a scientific statement from the Association of Cardiovascular Nursing and Allied Professions, European Association of Preventive Cardiology, and International Council of Cardiovascular Prevention and Rehabilitation"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-6011","authenticated-orcid":false,"given":"Rod S","family":"Taylor","sequence":"first","affiliation":[{"name":"Former ACNAP Science committee member, Professor of Population Health, School of Health and Well Being, University of Glasgow , Glasgow G12 8QQ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Fredericks","sequence":"additional","affiliation":[{"name":"ACNAP Science committee member, Professor, Daphne Cockwell School of Nursing, Toronto Metropolitan University , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Jones","sequence":"additional","affiliation":[{"name":"ACNAP Science committee member, Professor of Cardiovascular Nursing, Liverpool Centre for Cardiovascular Science, Liverpool John Moores University , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5852-1034","authenticated-orcid":false,"given":"Lis","family":"Neubeck","sequence":"additional","affiliation":[{"name":"ACNAP President, Professor and Head of Cardiovascular Health, Centre for Cardiovascular Health, Edinburgh Napier University , Edinburgh ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7335-2803","authenticated-orcid":false,"given":"Julie","family":"Sanders","sequence":"additional","affiliation":[{"name":"ACNAP Science committee chair, Director of Clinical Research, St Bartholomew\u2019s Hospital, Barts Health NHS Trust , West Smithfield ,","place":["UK"]},{"name":"Clinical Professor of Cardiovascular Nursing, William Harvey Research Institute, Queen Mary University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"De Stoutz","sequence":"additional","affiliation":[{"name":"ESC Patient forum representative, Member of \u2018Cuore Matto\u2019 and Global ARCH , Zumikon ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R","family":"Thompson","sequence":"additional","affiliation":[{"name":"EAPC representative, Professor of Nursing, School of Nursing and Midwifery, Queen\u2019s University Belfast , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepti N","family":"Wadhwa","sequence":"additional","affiliation":[{"name":"ACNAP Young community member, Associate Professor, MVPS College of Physiotherapy , Nashik ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7063-3610","authenticated-orcid":false,"given":"Sherry L","family":"Grace","sequence":"additional","affiliation":[{"name":"ICCPR Immediate past-Chair, Professor, Faculty of Health, York University , Toronto ,","place":["Canada"]},{"name":"KITE-Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"2026080909464318400_ehad225-B1","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group. 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