BACPR scientific statement: British standards and core components for cardiovascular disease prevention and rehabilitation

3 4 Secondary prevention, including blood pressure and cholesterol management and the prescription of cardioprotective medication, now also forms an integral part of an effective CR programme. 5 The current evidence base included under the 'umbrella' of CR has reported many variations in the 'dose' of individual or collective interventions (medical, lifestyle and psychosocial), which may therefore explain the variations of outcomes found in the studies included in the key systematic reviews on CR. 3 4 More recently published British evidence clearly shows that when the 'dose', at least of the exercise component, of CR is below those found in the more ideal research studies, the outcomes (functional capacity, quality of life and mortality) are poor. 6 The emerging evidence base however demonstrates that when doses of CR are commensurate with the more ideal studies, morbidity and mortality are reduced and there is a 23-56% reduction in costly unplanned hospital readmissions. 7 8 There is now increased emphasis on early CR commencing within 2 weeks of either discharge or diagnosis, with such a timeframe being safe, feasible, more clinically effective and with improved patient uptake and adherence. 9 10 It is from this collection of evidence on the benefit of early CR that the BACPR has enhanced its emphasis on the central component of Health Behaviour Change and Education ( figure 1 ) for achieving such goals as early commencement and reduced unplanned hospital readmissions.