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June 12, 2026European Journal of Preventive CardiologyOpen Access

Trends in mental health and behavioural risk factors of patients in exercise-based cardiac rehabilitation over 25 years: a retrospective cohort study

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Population

27,742 patients with cardiovascular diseases enrolled in a cardiac rehabilitation program at a large…

Design

Cohort

Key result

Over 25 years, cardiac rehabilitation participants showed increased median physical activity (150 to 180 mins/week) and decreased moderate/severe anxiety (14% to 10%, P<0.001).

Authors

AVA Marques VieiraMHM HausenJHJ Harris

Discussion

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Overview

High non-smoker prevalence in cardiac rehab supports sustained cessation focus; leaves open causal links to activity and mood trends.

Key Points

  • Examine 25-year trends in mental health and behavioural risk factors among participants of cardiac rehabilitation.
  • Observational retrospective cohort study of patients enrolled in a cardiac rehabilitation program from 2001 to 2025.
  • Analysis of self-reported physical activity, smoking status, and mental health scores using established scales (HADS, GAD-7, PHQ-9).
  • Statistical comparisons via one-way ANOVA and Chi-square analyses.
  • Median moderate-to-vigorous physical activity levels decreased from 150 minutes/week (2001-2005) to 90 minutes/week (2016-2020) but increased to 180 minutes/week (2021-2025, p<0.001).
  • Moderate/severe anxiety decreased from 14% (2001-2015) to 10% (2021-2025, p<0.001).
  • Depression scores improved, with normal range scores increasing, and moderate/severe depression decreasing to 4.6% (2021-2025, p<0.001).

Study Design

Type

Cohort (n=27,742)

Multicenter

No

Structured PICO

P
Population
27,742 patients (mean age 62 years, 29.5% women) with cardiovascular disease enrolled in a cardiac rehabilitation program between 2001 and 2025.
E
Exposure
Exercise-based cardiac rehabilitation over 25 years (grouped into 5-year enrollment intervals)
O
Outcome
Trends in mental health (HADS, GAD-7, PHQ-9 scores) and behavioural risk factors (moderate-to-vigorous physical activity, smoking status)patient reported

Main Result

p-value: p=<0.001

Over 25 years, cardiac rehabilitation participants in Canada showed encouraging recent improvements in physical activity and mental health, though smoking prevalence slightly increased.

Cite This Study

Vieira et al. (2026) conducted a cohort in Cardiovascular diseases (n=27,742). Time period (2001-2025) vs. Earlier time periods was evaluated on Trends in moderate-to-vigorous physical activity, smoking status, and mental health scores (p=<0.001). Over 25 years, cardiac rehabilitation participants showed increased median physical activity (150 to 180 mins/week) and decreased moderate/severe anxiety (14% to 10%, P<0.001).

synapsesocial.com/papers/6a2bd11d6550ea4541ffe8bahttps://doi.org/10.1093/eurjpc/zwag249.327
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiometabolic profiles of patients enrolled in exercise-based cardiovascular rehabilitation over 25 years: a retrospective cohort study2026
  2. 2Temporal trends in the sociodemographic profile of patients enrolled in cardiovascular rehabilitation over 25 years: a retrospective cohort study2026
  3. 3Risk factor outcomes following flexible delivery models in cardiac rehabilitation: rehabilitation in the real world2026
  4. 4Physical activity and sedentary behaviour in a phase III cardiac rehabilitation program: identifying vulnerable subgroups2026
  5. 5Mental Health and Quality of Life in Those Entering Cardiovascular Rehabilitation During the COVID-19 Pandemic2026