This review, conducted by The Cochrane Collaboration, evaluates the effectiveness of exercise-based cardiac rehabilitation compared to usual care in reducing mortality, morbidity, and modifiable cardiac risk factors in patients with coronary heart disease (CHD). The study includes 36 randomized controlled trials involving 8,440 patients, with 7,683 contributing to the total mortality outcome. Key findings include: - **Mortality**: Exercise-only rehabilitation reduced all-cause mortality by 27% (OR 0.73, 95% CI 0.54 to 0.98), while comprehensive cardiac rehabilitation reduced it by 13% (OR 0.87, 95% CI 0.71 to 1.05). - **Cardiac Mortality**: Exercise-only rehabilitation reduced cardiac mortality by 31% (OR 0.69, 95% CI 0.51 to 0.94) and comprehensive cardiac rehabilitation by 26% (OR 0.74, 95% CI 0.57 to 0.96). - **Non-fatal Myocardial Infarction**: No significant effect was seen in either intervention. - **Cholesterol**: Comprehensive cardiac rehabilitation significantly reduced total cholesterol and LDL cholesterol (pooled WMD -0.57 mmol/l and -0.51 mmol/l, respectively). - **Blood Pressure**: Significant reductions in systolic blood pressure were observed in the comprehensive cardiac rehabilitation group (pooled WMD -2.24 mmHg). The review concludes that exercise-based cardiac rehabilitation is effective in reducing cardiac deaths, but there is insufficient evidence to determine whether exercise-only rehabilitation is more beneficial than comprehensive cardiac rehabilitation. The study also highlights the need for larger, well-designed trials to explore the effects of rehabilitation on underrepresented groups, such as elderly people, women, and those with angina or heart failure.This review, conducted by The Cochrane Collaboration, evaluates the effectiveness of exercise-based cardiac rehabilitation compared to usual care in reducing mortality, morbidity, and modifiable cardiac risk factors in patients with coronary heart disease (CHD). The study includes 36 randomized controlled trials involving 8,440 patients, with 7,683 contributing to the total mortality outcome. Key findings include: - **Mortality**: Exercise-only rehabilitation reduced all-cause mortality by 27% (OR 0.73, 95% CI 0.54 to 0.98), while comprehensive cardiac rehabilitation reduced it by 13% (OR 0.87, 95% CI 0.71 to 1.05). - **Cardiac Mortality**: Exercise-only rehabilitation reduced cardiac mortality by 31% (OR 0.69, 95% CI 0.51 to 0.94) and comprehensive cardiac rehabilitation by 26% (OR 0.74, 95% CI 0.57 to 0.96). - **Non-fatal Myocardial Infarction**: No significant effect was seen in either intervention. - **Cholesterol**: Comprehensive cardiac rehabilitation significantly reduced total cholesterol and LDL cholesterol (pooled WMD -0.57 mmol/l and -0.51 mmol/l, respectively). - **Blood Pressure**: Significant reductions in systolic blood pressure were observed in the comprehensive cardiac rehabilitation group (pooled WMD -2.24 mmHg). The review concludes that exercise-based cardiac rehabilitation is effective in reducing cardiac deaths, but there is insufficient evidence to determine whether exercise-only rehabilitation is more beneficial than comprehensive cardiac rehabilitation. The study also highlights the need for larger, well-designed trials to explore the effects of rehabilitation on underrepresented groups, such as elderly people, women, and those with angina or heart failure.