Exercise-based cardiac rehabilitation (CR) for coronary heart disease (CHD) was evaluated in a Cochrane review, which included 63 randomized controlled trials (RCTs) involving 14,486 participants. The review found that exercise-based CR reduced cardiovascular mortality compared to no exercise control (risk ratio [RR] 0.74, 95% CI 0.64 to 0.86) but did not significantly reduce total mortality (RR 0.96, 95% CI 0.88 to 1.04). Exercise-based CR also reduced the overall risk of hospital admissions (RR 0.82, 95% CI 0.70 to 0.96) but had no significant impact on the risk of myocardial infarction (MI), coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI). The review identified that exercise-based CR improved health-related quality of life (HRQL) in most or all sub-scales compared to control, with five out of 20 trials reporting significant improvements. Four trial-based economic evaluations suggested that exercise-based CR could be cost-effective in terms of quality-adjusted life years (QALYs). The quality of evidence varied, ranging from low to moderate, with some outcomes showing high-quality evidence. The review highlighted that the majority of studies had poor reporting of methods and results, with a notable lack of information on participant characteristics, randomization, and blinding. However, more recent trials were better reported and included a more diverse population, including older and female participants. The review also noted that the population studied was predominantly lower risk individuals following MI or revascularization, and further well-conducted RCTs are needed to assess the impact of exercise-based CR in higher-risk CHD groups and those with stable angina. The review concluded that exercise-based CR reduces the risk of cardiovascular mortality but not total mortality. It also showed a significant reduction in hospitalization risk but not in MI or revascularization risk. The review emphasized the need for further research to better understand the effects of exercise-based CR in higher-risk populations and to include validated HRQL measures, explicitly report clinical event outcomes, and assess costs and cost-effectiveness.Exercise-based cardiac rehabilitation (CR) for coronary heart disease (CHD) was evaluated in a Cochrane review, which included 63 randomized controlled trials (RCTs) involving 14,486 participants. The review found that exercise-based CR reduced cardiovascular mortality compared to no exercise control (risk ratio [RR] 0.74, 95% CI 0.64 to 0.86) but did not significantly reduce total mortality (RR 0.96, 95% CI 0.88 to 1.04). Exercise-based CR also reduced the overall risk of hospital admissions (RR 0.82, 95% CI 0.70 to 0.96) but had no significant impact on the risk of myocardial infarction (MI), coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI). The review identified that exercise-based CR improved health-related quality of life (HRQL) in most or all sub-scales compared to control, with five out of 20 trials reporting significant improvements. Four trial-based economic evaluations suggested that exercise-based CR could be cost-effective in terms of quality-adjusted life years (QALYs). The quality of evidence varied, ranging from low to moderate, with some outcomes showing high-quality evidence. The review highlighted that the majority of studies had poor reporting of methods and results, with a notable lack of information on participant characteristics, randomization, and blinding. However, more recent trials were better reported and included a more diverse population, including older and female participants. The review also noted that the population studied was predominantly lower risk individuals following MI or revascularization, and further well-conducted RCTs are needed to assess the impact of exercise-based CR in higher-risk CHD groups and those with stable angina. The review concluded that exercise-based CR reduces the risk of cardiovascular mortality but not total mortality. It also showed a significant reduction in hospitalization risk but not in MI or revascularization risk. The review emphasized the need for further research to better understand the effects of exercise-based CR in higher-risk populations and to include validated HRQL measures, explicitly report clinical event outcomes, and assess costs and cost-effectiveness.