Cardiac Rehabilitation The objectives of contemporary exercise-based cardiac reha- bilitation are to increase functional capacity, decrease or alle- viate anginal symptoms, reduce disability, improve quality of life, modify coronary risk factors, and reduce morbidity and mortality rates.598,613,614 Core components include patient assessment; ongoing medical surveillance; nutritional coun- seling; BP, lipid, and diabetes mellitus management; smoking cessation; psychosocial counseling; physical activity coun- seling; exercise training; and pharmacological treatment, as Among 601099 US Medicare beneficiaries who were hospitalized for coronary conditions or revascularization procedures, mortality rates were 21% to 34% lower among participants in cardiac rehabilitation programs than among It has been suggested that contemporary reperfusion and cardioprotective drug therapies may dimin- ish the impact of adjunctive exercise-based cardiac reha- bilitation programs on post-MI survival rate. Taylor et al600 conducted a systematic review and meta-analysis of RCTs of cardiac rehabilitation with 6 months of follow-up. The study population included 8940 patients, a greater number were women (20% of the cohort), patients 65 years of age, and individuals who had undergone revascularization pro- cedures. Compared with usual care, cardiac rehabilitation was associated with a reduction in total and cardiac mor- tality rates of 20% and 26%, respectively. Subgroup analy- ses showed that the decreased mortality rates did not differ across several patient subsets, between programs limited to exercise and those providing more comprehensive secondary interventions, or between pre- and post-1995 studies, which suggests that the mortality benefits of cardiac rehabilitation persist in the modern era. However, despite these impres- sive outcomes, cardiac rehabilitation services remain vastly 11.1.4. 