I. The “weir” phenomenon of cardiovascular disease in China? With the triple pressure of rapid aging of China’s population, weak foundation of cardiovascular disease prevention and young age of the disease, the number of patients surviving with the disease has increased dramatically, while the thrombolytic and interventional treatment for acute myocardial infarction, and the drug treatment for heart failure have reduced the mortality rate of patients, we are facing the “weir” of cardiovascular disease in China. “. The management of this large group of people with disease involves huge investment of family and social medical resources and productivity consumption, which also increases the risk of a sudden increase in mortality due to a concentrated outbreak of the “weir” after a brief decline in cardiovascular disease mortality in China, further increasing the burden of cardiovascular disease. A large amount of medical resources are devoted to high-cost treatment of end-stage disease, with patients repeatedly hospitalized, re-stented, and re-operated; and in the case of heart failure, with extremely costly biventricular synchronized pacing, buried automatic defibrillation devices, and heart transplants. The current medical model is to “overhaul” the patient, rather than the maintenance of health and prevention of disease, health care for people is not as good as the maintenance of cars, because everyone is aware of the need for regular maintenance and after-sales service, but our people are suffering from no maintenance mechanism, after the treatment of disease because there is no post-operative rehabilitation treatment and constantly The embarrassing situation of returning to the clinic. How to effectively curb this trend? The establishment of a cardiac rehabilitation/secondary prevention system that fits the Chinese context is one of the key strategies. In the international medical community, William Herberden, a British physician in the 18th century, first described the symptoms of angina pectoris and first proposed the idea that exercise in CVD patients could help in rehabilitation. The concept of cardiac rehabilitation has evolved from a core focus on patient exercise training before the 1980s to an integrated model of service care that combines rehabilitation and secondary prevention in an integrated manner. (1) Definition and purpose of cardiac rehabilitation/secondary prevention: To provide comprehensive long-term medical care and services for patients with cardiovascular disease, to minimize the adverse physical and psychological effects of cardiovascular disease, to improve psychological, social and occupational status, and to effectively improve patients’ quality of life. (2) Target population of cardiac rehabilitation/secondary prevention: Patients with one or more of the following conditions within one year, such as myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, post-coronary artery bypass grafting, etc., now extended to chronic heart failure and peripheral artery disease. (3) The contents of cardiac rehabilitation/secondary prevention include: comprehensive medical assessment of patients, training of patients’ disease self-management skills, lifestyle change guidance (smoking cessation/diet/exercise/sleep management), evidence-based medication use, quality of life assessment and improvement, vocational rehabilitation, and resumption of work within one’s capabilities. (4) Cardiac rehabilitation/secondary prevention requires an integrated team to provide comprehensive health care services and a reasonable rehabilitation team that should include physicians, nurses, physical therapists, exercise rehabilitators, pharmacists, social workers, and family members of the patient to communicate and coordinate together to help the patient recover. (5) Phases of cardiac rehabilitation/secondary prevention: The different phases of the cardiac rehabilitation process are divided into four phases. Phase1, rehabilitation prevention during hospitalization for patients with myocardial infarction and acute coronary syndrome; Phase2, early post-discharge outpatient preventive rehabilitation services, with a course of treatment usually lasting 3-6 months and further continuous up to 9 months to 1 year; Phase3, distant outpatient preventive rehabilitation. Phase4, community-based home preventive rehabilitation, or H2H (Hospital to Home). (6) Cardiac rehabilitation/secondary prevention is a multi-win system: clinical studies have shown a 20% reduction in overall mortality and a 30% reduction in cardiovascular mortality with cardiac rehabilitation/secondary prevention. For patients, life expectancy is prolonged and quality of life is improved; for hospitals, management is improved, medical quality and efficiency are improved, unreasonable medical cost growth is controlled, net benefits are increased, and medical service and social satisfaction are improved; for the state and social health insurance, medical resources are used and saved rationally. III. The long road of cardiac rehabilitation in China In the era of planned economy, cardiac rehabilitation adopted the Soviet model, i.e. physiotherapy departments and sanatoriums. the Guangzhou Conference held in 1978 promoted the change from the pure biomedical model to the psycho-biological-social integrated medical model. At present, the dilemma of cardiac rehabilitation is as follows: (1) Rehabilitation in China is limited to physical rehabilitation only, and no real cardiac rehabilitation has been carried out; (2) Cardiac rehabilitation is not supported by medical insurance policies. (2) Cardiac rehabilitation is not supported by medical insurance policy. The current fee mechanism makes the economic income return of cardiac rehabilitation work low, and patients and families lack awareness of the significance and importance of cardiac rehabilitation and cannot afford the medical expenses of rehabilitation; (3) There is no systematic training and access system for cardiac rehabilitation personnel, and there is a lack of talents and a lack of rehabilitation knowledge, skills and equipment; (4) The academic community lacks understanding of the theory and practice of cardiac rehabilitation and does not pay attention to it. Some hospitals that have initially launched cardiac rehabilitation also narrowly understand cardiac rehabilitation as patient exercise capacity assessment and training, and do not implement enough psychological, quality of life and vocational rehabilitation. In many hospitals, rehabilitation is still at the clinical research stage and is not really implemented at the practical level of healthcare. With the further advancement of health care system reform, cardiac rehabilitation in China has ushered in an early spring and February. The development of rehabilitation medicine is facing four favorable conditions: First, the Party and government and the community are paying increasing attention to rehabilitation medical services. Rehabilitation medicine is the short board in China’s medical service system, and the construction and development of rehabilitation medicine should be incorporated into the big picture of medical reform. Talent training and economic policies are the lifeline for the development of rehabilitation medicine; secondly, economic and social development gives rise to the demand for rehabilitation services. With the improvement of China’s economic level and the increasing acceleration of the aging process, the demand for rehabilitation medical services is huge, the development prospect of the rehabilitation industry is promising, and private medical capital has a strong interest in rehabilitation; third, the reform of public hospitals provides important support for strengthening rehabilitation medical work; fourth, the precipitation obtained by the unremitting efforts of several generations of cardiac rehabilitation people, China has initially formed a team of old, middle-aged and young people who are determined to carry out the cause of cardiac rehabilitation. Some academic conferences have set up special sessions on rehabilitation. At last, China’s rehabilitation medicine has an important historical opportunity for development. 4. Ten-year plan for China’s cardiac rehabilitation/secondary prevention system (1) Organization and strengthening of academic institutions. The Society of Cardiac Rehabilitation will be strengthened, and more experts and professors will be attracted to the cause of cardiac rehabilitation/secondary prevention, and professional journals will be further organized, high-level international and domestic academic conferences will be held, clinical research on cardiac rehabilitation/secondary prevention in China will be promoted, and expert consensus and guidelines on cardiac rehabilitation suitable for Chinese conditions will be formulated. (2) Government-led, social mobilization, multi-participation, and formation of synergy. In particular, priority should be given to encouraging the input and participation of private capital and foreign investment. (3) Conduct pilot projects and explore models and mechanisms. We can learn from the model of Xiangya Hospital, where general hospitals run rehabilitation departments or rehabilitation branches, establish rehabilitation centers, set up specialties, and train high-end academic talents. (4) Improve talent training and access mechanisms. For example, nurse training and transfer, recruitment and training of medical school graduates after graduation, short-school rehabilitation schools and rehabilitation training courses, medical school rehabilitation medicine departments (faculties) and training of undergraduates, postgraduates, and innovation teams, and tightening the construction of a professional certification system for rehabilitation practitioners.