Australia faces a growing challenge in cardiovascular care as the number of people living with heart disease rises, despite significant progress in reducing mortality rates over the past 60 years. Even as deaths from heart disease have fallen by more than 75%, the country is bracing for a predicted 10-fold increase in the number of people living with the condition worldwide by 2050, placing a strain on the healthcare system.
Approximately 500,000 Australians are hospitalised annually with a heart condition, and survivors face a ten-fold higher risk of future heart attacks. Within three years of discharge, 40% are readmitted to hospital, and 20% die, resulting in an annual financial burden exceeding $14 billion. Experts argue that reimagining cardiac rehabilitation is crucial to future-proofing the nation’s cardiac care system.
Cardiac rehabilitation, a cornerstone of recovery after a heart event for six decades, traditionally involves supervised exercise, education, and psychological support delivered over 6-8 weeks. Programs have been shown to reduce recurrent events, hospitalisations, and improve quality of life, aiding a return to work and community life. However, these programs are underutilised, underfunded, and access is unevenly distributed, with less than half of eligible patients receiving a referral and only a fraction attending.
More than 375,000 Australians miss out on this vital stage of recovery each year, according to researchers working to improve access and quality of care. The term “cardiac rehabilitation” itself is being questioned, as it may limit the scope to only ‘cardiac’ diagnoses and imply a finite period of recovery rather than promoting lifelong cardiovascular health.
Ross, a train driver from the Gold Coast, exemplifies the challenges faced by many Australians. Following a heart procedure in 2025, he received minimal follow-up care and proactively sought support to rebuild his confidence, and hope. He now facilitates peer support sessions for others living with heart disease, highlighting the importance of connection and shared experience in recovery. He shared his story as part of the World Heart Federation’s ‘Beats of Change’ series, produced in collaboration with BBC StoryWorks, stating that “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.”
Researchers at SOLVE-CHD, a National Health and Medical Research Council (NHMRC) Synergy Grant initiative, are working to bridge the gap between evidence-based practices and access to care. The multidisciplinary team is redesigning rehabilitation delivery to be more personalised, digital, and equitable. One project, the Heart2Heart clinical trial, is evaluating a digital peer support application to connect people living with heart disease, regardless of location.
SOLVE-CHD aims to establish cardiac rehabilitation as a consistent, accessible, and integral part of heart care, rather than an afterthought. The initiative focuses on generating national data, quality benchmarks, and implementation tools to strengthen service delivery across Australia and empower clinicians to deliver best-practice care.
Julie Redfern, Director of the Institute for Evidence-Based Healthcare at Bond University and an Adjunct Professor at the University of Sydney, and her colleagues Robyn Gallagher, Tom Birffa, and Dion Candelaria, are collaborating with the World Heart Federation to develop a modern Roadmap outlining a pathway to lifelong cardiovascular health for countries worldwide. They emphasize the need to address inequities in access and quality of care, ensuring diverse groups are adequately represented.
The researchers call for a collective effort involving clinicians, policymakers, and researchers to prioritise patient referrals, advocate for program expansion, and recognise post-discharge care as vital for lowering long-term risk. They also stress the importance of listening to those with lived experience to improve reach, quality of care, productivity, and system efficiency.
