Background: Cardiac rehabilitation (CR), despite numerous evidence of a positive impact on morbidity and mortality, still remains underutilized due to multifactorial reasons. Physician endorsement has been shown to be a very powerful predictor of CR referral. The objective of the study was to describe physicians' attitudes and preferences regarding referral of patients to CR. Methods: A cross-sectional survey of a stratified random sample of 160 physicians specializing in cardiology was conducted at the Philippine Heart Center. One hundred and four physicians responded (65% response rate) to a survey that investigated clinical factors and perceptions affecting referral. Included in the survey was a hypothetical case scenario that elicited open-ended responses affecting physician management preferences. Results: About 78.9% of the physicians stated that they would refer the hypothetical case to CR although there were varied responses in their management practices. The most important factor affecting CR referral was financial limitation, followed by geographic location and issues on program accessibility and benefit. While there is general agreement regarding knowledge of the indications of CR, there is a disparity in the responses with regard to actual referral and management preferences. Conclusions: Financial considerations, accessibility, perceived benefit, and health-care system-related aspects are some of the identified factors that affect physician preferences toward referral to CR. Assessment of physician attitudes and factors affecting CR referral practices provides insight regarding potential targets of improvement to ensure adequate CR referral and provision.

South Asians (Indians, Bangladeshis, Pakistanis and Sri Lankans) have very high incidence of cardiometabolic diseases, such as hypertension, central abdominal obesity, metabolic syndrome, type-2 diabetes, ischemic heart disease and stroke. To create awareness, develop educational and a prevention program, a professional society was started at the University of Minnesota in 1993. This society (South Asian Society on Atherosclerosis Thrombosis) organized international conferences in India every other year, on the topic of "Atherosclerosis and Thrombosis" and published several monographs on this subject. During the same period, another sister society, Indian Society of Atherosclerosis Research (ISAR) was started in India, which organized conferences on topics related to basic research and clinical aspects of atherosclerosis. Together, these professional societies have contributed significantly to our understanding of chronic cardiometabolic diseases. SASAT is currently located at the Division of Clinical and Preventive Cardiology, Medanta, The MediCity, New Delhi, India and is affiliated with the professional journal; Journal of Clinical and Preventive Cardiology. For information on ISAR, readers are urged to visit their web site: www. isar.co.in.