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Mar 09, 2013

Despite Lifesaving Benefits, Fewer Women Than Men Get Cardiac Rehab

Women with coronary artery disease can improve their heart health and reduce their risk of dying from heart disease by attending cardiac rehabilitation.

Coronary artery disease—a gradual build-up of plaque in the heart’s arteries—is the most common type of heart disease. It’s also the leading killer of both men and women in the United States.

New data show women with CAD who completed a 12-week cardiac rehabilitation program are two-thirds less likely to die than those who are not referred to this program. The mortality benefit derived from taking part in cardiac rehab is also more striking in women than men with the same condition, yet referrals and attendance among women fall short, according to research presented at the American College of Cardiology’s 62nd Annual Scientific Session in San Francisco this week. This meeting brings together cardiologists and cardiovascular specialists from around the world each year to share the newest discoveries in treatment and prevention.

Cardiac rehab programs—long recommended by the American College of Cardiology and other groups—are now offered in most hospitals and medical centers in the U.S. and elsewhere. These structured programs are tailored to individual patients and are designed to help lower the risk of future heart problems. They include a mix of supervised exercise, nutrition counseling, stress management, smoking cessation assistance (if needed) and education about the disease process, including how heart patients can take control of their own health and improve their outcomes.

“Cardiac rehabilitation can be a lifesaver, but many [women] aren’t being referred, and even when they are, they are less likely to attend,” said Jillian Colbert, MD, cardiology fellow in training at the University of Calgary, and the study’s lead investigator, who said the results validate the results of earlier smaller studies.  “But cardiac rehabilitation programs have been proven to improve outcomes and can significantly increase their lifespan.”

In this study, only one in three women was referred to cardiac rehab. Of those, only half actually attended. Compared to men, women had lower rates of referral and attendance. They were also older and had a higher prevalence of heart failure and diabetes. In some cases, just being referred seems to have a benefit for women—even if they elect not to attend.

So, why are so many women not attending rehab? There are many theories, but Dr. Colbert and her colleagues suspect it’s because women often juggle many family obligations and tend to put themselves—and their own health—last. Previous studies have also pointed to transportation issues, the need for insurance preapprovals and delays in scheduling the first appointment as common hurdles.

“I would encourage patients to ask their doctor if there is a local cardiac rehabilitation program and if they can be referred,” Dr. Colbert said. “These programs quite literally add life to your years and years to your life and the lives of your loved ones.”

There are important psychosocial benefits too. Through cardiac rehab, women often find encouragement and develop friendships with other women who have similar heart problems.

Questions for You to Consider

  • Who else can benefit from cardiac rehab?
  • In addition to people with coronary artery disease, those recovering from a heart attack, heart failure, or a heart surgery or procedure (for example, angioplasty and stenting, valve replacement or a pacemaker or defibrillator) are offen referred and can benefit from this type of program.
  • How long does a cardiac rehab program last?
  • Many are 12-week programs, but it’s highly individual. Some people need less time; others might need to continue rehab for months, even years. Talk with your health care team about what is best for you.

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