Unlocking the Potential of Cardiac Rehabilitation: From Psychological Barriers to Treatment Targets

To provide an overview of the dual role of psychological factors: as determinants of cardiac rehabilitation (CR) engagement and long-term behavior change, and as consequences and treatment targets. CR is central to cardiovascular care but remains underused. Beyond systemic and logistical barriers, psychological factors influence whether patients participate in and complete CR and maintain a healthy lifestyle post-CR. Psychological distress is common in patients eligible for CR and negatively affects quality of life and prognosis. Without addressing these factors, CR jeopardizes remaining an effective but underused intervention which full potential is not realized. Psychological factors should be understood both as barriers to CR participation, completion, and long-term benefit, and as actionable targets to improve these outcomes. They should therefore not be limited to intake risk screening but assessed and acted upon across the CR pathway to support engagement and enhance sustained behavior change and patient-centered recovery.