Pritikin Intensive Cardiac Rehab 449C ardiac rehabilitation (CR) is a medically supervised treatment program designed to promote optimal recovery after a cardiac event or procedure and to reduce the risk for future cardiac events in patients with cardiovascular disease (CVD). 1,2 Exercise is the central focus of CR, with additional instruction on healthy dietary patterns and lifestyle behaviors that impact cardiovascular risk. Cardiac diagnoses that are approved by the Centers for Medicare & Medicaid Services (CMS) for referral to CR include myocardial infarction, coronary artery bypass surgery, stable angina pectoris, heart valve repair or replacement, coronary angioplasty or coronary stenting, heart transplant, and heart failure with reduced ejection fraction. 3 Cardiac rehabilitation has proven to be beneficial for reducing hospitalizations, reinfarction, cardiac mortality, all-cause mortality, and improving daily function, depressive symptoms, and quality of life among patients with CVD. 1,[4][5][6][7][8][9][10][11][12][13] Traditional CR typically includes up to 36 1-hr, supervised, monitored exercise sessions over 12-18 wk. In August 2010, the CMS expanded coverage for CR to include intensive cardiac rehabilitation (ICR) programs, 14 based on demonstrated improvements in specific endpoints, including less progression of coronary heart disease, reduced need for coronary bypass surgery, and reduced need for percutaneous coronary interventions. Intensive cardiac rehabilitation includes all the components of traditional CR plus up to 36 additional 1-hr sessions, for a total of 72 sessions during a period of up to 18 wk.Three ICR programs have been approved by the CMS 15 : the Ornish Reversal Program, the Pritikin Program, and the Benson-Henry Institute Cardiac Wellness Program at Massachusetts General Hospital. The Pritikin-certified ICR program is a comprehensive lifestyle change program based on three pillars: safe and effective exercise, a healthy eating plan, and a healthy mindset. 16 The Pritikin diet was designed by Nathan Pritikin in 1955 to mimic the diet of the Tarahumara Indians of Mexico, which was high in unprocessed, complex carbohydrates, fiber, and plant sterols and low in fat, cholesterol, and simple sugars. The original Pritikin program began in 1976 as a residential lifestyle change program to reduce the risk of recurrent cardiovascular events. 17 Favorable outcomes of the Pritikin Longevity Center 3-wk residential program included clinically meaningful reductions in CVD risk factors (eg, 23% decrease in total and low-density lipoprotein cholesterol, 18 33%