Abstract
BackgroundCardiac rehabilitation programs reduce cardiovascular events and mortality in ischemic heart disease patients. The aim of this study was to assess gender differences among ischemic heart disease patients enrolled in a cardiac rehabilitation program regarding adherence to the program, as well as, changes in clinical, laboratory, and echocardiographic parameters.ResultsA prospective study that included 30 men and 30 women with stable ischemic heart disease who had been totally revascularized by percutaneous coronary intervention. Patients were enrolled in a 12-week cardiac rehabilitation program. Assessment of demographics, anthropometric measurements, risk factors, and functional capacity was performed. Lipid profile, glycated hemoglobin, and left ventricular ejection fraction were assessed. Assessments were performed at baseline and after completion of the program.Time to enrollment in the program was prolonged for women 39.17 ± 40.49 vs. 19.77 ± 10.26 days (p = 0.014). At baseline, more women were diabetic (p = 0.004), hypertensive (p = 0.02), had a larger waist circumference (p = 0.022), a higher BMI (p = 0.011), and higher HbA1c (p = 0.033). More men were active smokers (p < 0.001). After completion of the program, it was found that men attended 19.1 ± 4.77 (79.6%) sessions compared to 15.7 ± 5.72 (65.4%) sessions for women (p = 0.015). Women had more reduction in diastolic BP − 10.93 ± 8.94 vs. − 5.47 ± 12.57 mmHg (p = 0.058). The magnitude of reduction in resting heart rate was significant in men (p = 0.018) but not in women (p = 0.376). The magnitude of reduction in serum total cholesterol and triglycerides was more in men (p = 0.018 and p = 0.014). Women showed more reduction in HbA1c (p = 0.052).ConclusionMen are more adherent to cardiac rehabilitation programs. Recruitment of women is significantly delayed. Women have a higher cardiovascular risk burden in the form of prevalence of diabetes, hypertension, and obesity. Completion of a cardiac rehabilitation program causes a reduction in BMI, waist circumference, blood pressure measurements, total cholesterol, triglycerides, LDL-C, HDL-C, HbA1c, and LVEDD with an increase in LVEF in both genders. Men show more reduction in resting HR, total cholesterol, and triglyceride levels while women show more reduction in diastolic BP and HBA1c.
Highlights
Cardiac rehabilitation programs reduce cardiovascular events and mortality in ischemic heart disease patients
Baseline demographic and clinical data On comparing men and women at baseline, we found that the time to enrollment in the cardiac rehabilitation program was prolonged for women 39.17 ± 40.49 vs. 19.77 ± 10.26 days (p = 0.014); a larger proportion of women were diabetic (p = 0.004) and hypertensive (p = 0.02); women had a larger waist circumference 108.43 ± 8.31 vs. 102.07 ± 12.3 cm (p = 0.022) and higher Body mass index (BMI) 32.67 ± 5.3 vs. 29.47 ± 4.07 kg/m2 (p =0.011)
There was no difference between men and women at baseline regarding age, presence of dyslipidemia, distribution of New York Heart Association (NYHA) functional class, blood pressure measurements, resting heart rate, marital status, and level of education (Table 1)
Summary
Cardiac rehabilitation programs reduce cardiovascular events and mortality in ischemic heart disease patients. The aim of this study was to assess gender differences among ischemic heart disease patients enrolled in a cardiac rehabilitation program regarding adherence to the program, as well as, changes in clinical, laboratory, and echocardiographic parameters. Cardiovascular disease is the leading cause of death among men and women in most developed countries. It was thought that cardiovascular disease mainly affects men. Women and men share the same traditional risk factors for ischemic heart disease. Ischemic heart disease symptoms in women are usually atypical and different from men which leads to delayed presentation, delayed diagnosis or misdiagnosis putting women at an increased risk. Women usually present more complications and worse functional outcomes compared to men [4,5,6]
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