Medium-term effects of cardiac rehabilitation in Germany: systematic review and meta-analysis of results from national and international trials

Contrary to international practice, cardiac rehabilitation (CR) in Germany is predominantly offered as comprehensive inpatient treatment lasting for 3 weeks. Evidence for this kind of health care is poor, comprising observational cohort studies only.

We conducted a systematic search for relevant German studies (1990–2004). International studies were selected from recent meta-analyses. Medium-term (12 month) results for blood lipids, blood pressure, functional capacity and psychological wellbeing, as well as cardiac morbidity and mortality are reported.

For most outcomes, effect sizes in national studies are poorer than those from international interventions or, in the case of blood pressure and depression, even poorer than international controls.

Altogether, our analysis does not suggest that comprehensive inpatient rehabilitation treatment is superior to international practice of long-term outpatient rehabilitation.