Abstract-The American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation recognize that all cardiac rehabilitation/secondary prevention programs should contain specific core components that aim to optimize cardiovascular risk reduction, foster healthy behaviors and compliance to these behaviors, reduce disability, and promote an active lifestyle for patients with cardiovascular disease. This update to the previous statement presents current information on the evaluation, interventions, and expected outcomes in each of the core components of cardiac rehabilitation/secondary prevention programs, in agreement with the 2006 update of the American Heart Association/American College of Cardiology Secondary Prevention Guidelines, including baseline patient assessment, nutritional counseling, risk factor management (lipids, blood pressure, weight, diabetes mellitus, and smoking), psychosocial interventions, and physical activity counseling and exercise training.

The American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation recognize that all cardiac rehabilitation/secondary prevention programs should contain specific core components that aim to optimize cardiovascular risk reduction, foster healthy behaviors and compliance to these behaviors, reduce disability, and promote an active lifestyle for patients with cardiovascular disease. This update to the previous statement presents current information on the evaluation, interventions, and expected outcomes in each of the core components of cardiac rehabilitation/secondary prevention programs, in agreement with the 2006 update of the American Heart Association/American College of Cardiology Secondary Prevention Guidelines, including baseline patient assessment, nutritional counseling, risk factor management (lipids, blood pressure, weight, diabetes mellitus, and smoking), psychosocial interventions, and physical activity counseling and exercise training.

EART FAILURE IS A NATIONAL epidemic, affecting nearly 5 million persons in the United States, with an additional 550 000 diagnosed each year. 1 This burden is disproportionately borne by black Americans, who have a higher incidence and prevalence of heart failure than members of other racial groups. 1 Despite this greater burden, black patients may receive less intensive and poorer-quality care for heart failure than whites. 2-5 Some studies, however, suggest that black patients receive similar quality of care as members of other racial groups. 6-10 Because prior studies evaluated patients treated in selected centers or regions 6-10 and assessed treatment or utilization patterns and not objective measures of quality of care, 3,9,10 it is unclear if reported racial differences reflect shortfalls in care or appropriate treatment or are representative of current national practice patterns. A national evaluation of racial patterns of heart failure care is timely given the

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