Advancing Scientific Cardiac Rehabilitation　- Retrospect and Prospect.

On the 30th anniversary of the founding of the Japanese Association of Cardiac Rehabilitation in 1995, this article provides an overview of the past and future of cardiac rehabilitation (CR) as science. The development of CR thus far has undoubtedly been supported not only by clinical needs but also by numerous pieces of scientific evidence regarding its effectiveness. In the first part of this article, I aim to scrutinize past evidence on CR scientifically, because all evidence must be critically examined. In the latter part, I will look ahead to the future of CR. Recently, there has been a rapid increase in very elderly frail patients with multiple comorbidities. In the near future, treatment for these patients will not be completed with acute-phase interventions targeting a single organ, and hence, patient outcome goals are expected to shift from improving survival prognosis to improving physical activity capacity and quality of life, indicating a growing need for CR like never before. Given the current rise in patients in the area where evidence is lacking, a new evidence-based CR that is not simply an extension of traditional practices is required. Taking into account the changes in the times, we must steadfastly pursue scientific CR by creating new evidence.