Cardiac patients may be underserved globally due to lack of rehab programs, according to a recent study.

Researchers from York University in Canada suggest that rehabilitation programs must become an integral part of cardiac care to significantly reduce the burden of living with heart disease, one of the most common chronic diseases and causes of death globally.

"Cardiac rehabilitation is a cost-effective program offering heart patients exercise, education and risk reduction," Sherry Grace, researcher and professor, said in a statement.

However, Grace said that despite these benefits cardiac rehabilitation is vastly underused, and insufficiently implemented, with only 39 percent of countries providing any.

Heart disease has become an epidemic in low-income and middle-income countries, and cardiac rehab can reduce the socio-economic impact of the disease by promoting return to work and reducing premature mortality, Grace, who is also the director of research at the GoodLife Fitness Cardiovascular Rehabilitation Unit at the University Health Network, said in a statement.

Grace noted that rehab participation results in 25 percent less death, lower re-hospitalization rates and better quality of life. However, while 68 per cent of high-income countries have cardiac rehabilitation, only 23 percent of low-income and middle-income countries do,

"If supportive health policies, funding, physician referral strategies and alternative delivery modes are implemented, we could reduce the ratio from one cardiac rehab program per 6.4 million inhabitants in a middle income country like Paraguay, to the one program per 102,000 available in the [United States], a high income country," adds Grace.

Low-income countries such as Afghanistan, Bangladesh and Kenya have one rehab program each for their entire population.

Grace conducted the review with Karam Turk-Adawi in the Cardiovascular Rehabilitation & Prevention Unit, University Health Network (UHN), and Dr. Nizal Sarrafzadegan, director of Isfahan Cardiovascular Research Center at Isfahan University of Medical Sciences in Iran.

The findings were recently published online at Nature Reviews Cardiology.