CR is recommended for all patients after CABG, with the referral ideally performed early postopera- tively during the surgical hospital stay (Class I; Level of Evidence A). Self-Management of Cardiovascular Disease After CABG, CR programs help patients develop self-man- agement skills to facilitate lifestyle and behavior modifi- cation. Self-management is the process by which patients assume control of their health-related behaviors.342 Ultimately, patients decide what they will eat, if they will exercise, and what medication they will take. As healthcare experiences a paradigm shift from physician-centered to patient-centered care, CR programs play an integral role in education and transitioning patients to adopt health-related behaviors.342 CR personnel can act as health coaches, providing self-manage- ment support, collaborating with patients to establish goals, and developing problem-solving skills to foster risk factor modification. Successful CR programs stimulate patients to acquire the knowledge, skills, and confidence necessary to alter health-related behavior.342 346 The Reduction of Atherothrombosis for Continued Health (REACH) international registry reported that among patients who have undergone CABG, when secondary prevention goals are not met at 1 year, the incidence of adverse cardio- vascular events increases, regardless of the number of risk factors present at baseline. This highlights the importance of CR programs to help patients achieve their goals and to improve long-term outcomes.212 Multiple barriers exist to the adoption of preventive therapies, including knowledge defi- cit, ambivalence, comorbidities, preconceived beliefs, lack of support, employment, and readiness for change.347 349 For example, older patients with comorbidities who live alone are more likely after 1 year to remain sedentary and to have poor medication and diet compliance.350 Interventions for self-management of risk factors should be individualized to meet specific sex concerns. 