School of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; International Council of Cardiovascular Prevention and Rehabilitation.
School of Health Policy and Management, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
Prog Cardiovasc Dis. 2016 Nov-Dec;59(3):303-322. doi: 10.1016/j.pcad.2016.08.004. Epub 2016 Aug 17.
Cardiovascular disease (CVD) is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be efficacious and cost-effective for secondary prevention in high-income countries. Given its affordability, CR should be more broadly implemented in middle-income countries as well. Hence, the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) convened a writing panel to recommend strategies to deliver all core CR components in low-resource settings, namely: (1) initial assessment, (2) lifestyle risk factor management (i.e., diet, tobacco, mental health), (3) medical risk factor management (lipids, blood pressure), (4) education for self-management; (5) return to work; and (6) outcome evaluation. Approaches to delivering these components in alternative, arguably lower-cost settings, such as the home, community and primary care, are provided. Recommendations on delivering each of these components where the most-responsible CR provider is a non-physician, such as an allied healthcare professional or community health care worker, are also provided.
心血管疾病（CVD）是一种全球性的流行病，在很大程度上是可以预防的。心脏康复（CR）已被证明在高收入国家对二级预防是有效且具有成本效益的。鉴于其可负担性，CR 也应该在中等收入国家更广泛地实施。因此，国际心血管预防与康复协会（ICCPR）召集了一个写作小组，为在资源有限的环境下提供所有核心 CR 组成部分的策略提出建议，即：（1）初始评估；（2）生活方式风险因素管理（即饮食、烟草、心理健康）；（3）医疗风险因素管理（血脂、血压）；（4）自我管理教育；（5）重返工作岗位；（6）结果评估。提供了在家庭、社区和初级保健等替代的、成本相对较低的环境中提供这些组成部分的方法。还就由非医生（例如，医疗保健专业人员或社区卫生工作者）作为最负责任的 CR 提供者提供这些组成部分中的每一个的建议。
