The Role of Nurses in Cardiovascular Disease Secondary Prevention: Partnering with Patients in Cardiac Rehabilitation and Digital Health

ABSTRACT Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, underscoring the importance of effective secondary prevention. Cardiac rehabilitation (CR) is a comprehensive, multidisciplinary approach integrating exercise training, patient education, cardiovascular risk-factor modification, and behavioral support. Despite its established benefits, CR remains substantially underutilized because of barriers at the patient, clinician, organizational, and health-system levels. This article examines the importance of nurses partnering with patients across the CR continuum to advance patient-centered education and communication, shared decision-making, behavior change, and long-term self-management. First, we describe CR as a model of comprehensive secondary prevention and examine barriers to referral, enrollment, participation, and equitable access, including challenges relevant to resource-limited settings. Second, we focus on patient education and counseling as interactive, individualized processes that expand beyond information provision to build patients’ knowledge, skills, confidence, and capacity for behavior change and self-management. We highlight nursing strategies including assessment of learning needs and readiness for change, health-literacy-responsive communication, teach-back, motivational interviewing, tailored counseling, shared decision-making, and collaborative goal setting. Third, we consider how digital health technologies can extend patient education, communication, self-monitoring, and feedback within and beyond traditional CR settings, and discuss emerging applications and current limitations of artificial intelligence. Finally, we identify priorities for nursing practice, including improving identification and referral, strengthening education and communication, promoting patient partnership, expanding equitable access, appropriately integrating technology, and supporting the transition from CR to lifelong secondary prevention. Across these domains, nurses are well-positioned to integrate clinical expertise with patient-centered education and communication, partnering with patients and families to address barriers, support informed decision-making, and facilitate sustained behavior change. Digital and AI technologies have the potential to extend these partnerships beyond traditional CR settings. Strengthening these partnerships across the CR continuum can support the transition from structured CR to long-term self-management and lifelong cardiovascular health.