Problem: Can you annotate Despite the clear benefit of CR to patients with CAD, referral rates and rates of participation remain low. In one study, whereas 62% of patients above age 65 were referred to CR after MI, only 33% of these attended one session [25]. Rates are even lower among women and minorities [26]. The reasons for low referral rates are not clear, but include transportation problems, lack of insurance, financial need to return to work, and other barriers. It is also noted that many physicians underestimate the value of exercise training, risk management and psychosocial support in CAD patients and without physician referral, participation is unlikely