Participation in cardiac rehabilitation (CR) is Class I recommendation to mitigate cardiovascular disease burden, a leading cause of disability globally. CR adherence varies greatly and there is little evidence on which to base minimum dose recommendations, hence, the aims of this thesis are to describe dose received, including rate of intervening events, impact of risk factors burden on CR attendance by component and then ascertain countries that need to augment their CR dose. I have undertaken two interlinked research studies. The first study on twenty years cohort demonstrated that, in 1/6 of patients, CR attendance and completion were impacted by intervening events, and the remaining cohort attended about half of sessions prescribed. Many patients took advantage of components specific to their risk factors. In the 2nd study, CR is not available in almost half of the countries in the world, and many countries may need to increase their CR dose
