Prevention & lipidsMeta-analysis
Effectiveness, safety, costs, and delivery considerations of exercise-based cardiac rehabilitation in low- and middle-income countries: a systematic review and meta-analysis of randomized controlled trials
- Systematic review and meta-analysis of randomised controlled trials
- random-effects meta-analysis
- meta-regression
- GRADE
Authors' conclusion
This updated review indicates that exercise-based CR in LMICs improves exercise capacity and HRQoL consistent with evidence from high-income settings. However, due to substantial statistical heterogeneity, risk of bias, and inconsistent data collection, the overall certainty of these findings is low.
Study context
- Population
- Patients with heart disease in low- and middle-income countries
- Participants
- 6,682 patients · 29 randomised controlled trials (RCTs)
- Comparison
- Exercise-based cardiac rehabilitation vs control
Pooled result
Exercise capacity
SMD
0.71
95% CI 0.47–0.96
CR vs Control
SMD 0.71 (95% CI 0.47–0.96)
As reported in the abstract
Further pooled results
| Outcome | MD (95% CI) | |
|---|---|---|
| HRQoL: SF-12/36 physical component | 5.0 (0.5–9.4) | |
| HADS-Anxiety | 1.19 (0.97–1.42) | |
| HADS-Depression | 1.03 (0.20–1.85) | |
| −50510Difference (linear scale) |
PHQ-9, GAD-7
- No consistent effect
Mortality, hospitalisation, safety, costs
- Few trials reported data
Original publication
Effectiveness, safety, costs, and delivery considerations of exercise-based cardiac rehabilitation in low- and middle-income countries: a systematic review and meta-analysis of randomized controlled trials. Eur J Prev Cardiol. Published 12 September 2026. doi:10.1093/eurjpc/zwag460
Summarised from the published abstract; every number is checked against it