Greater Improvements in Health-Related Quality of Life Following Cardiac Rehabilitation Among Women and Ethnic-Minority Patients

BACKGROUND: Cardiac rehabilitation (CR) is a cornerstone of secondary prevention following cardiovascular events; however, variability in its benefits across sociodemographic groups remains incompletely understood. OBJECTIVE: To evaluate differences in changes in health-related quality of life (HRQoL) following CR across sociodemographic and clinical characteristics. METHODS: In this prospective study, 464 consecutive patients participating in a CR program were assessed. Using the Short-Form Survey-12 questionnaire, HRQoL was evaluated at baseline and upon program completion. Functional capacity (six-minute walk test and exercise cardiac stress test), clinical characteristics, and adherence rates were analyzed across subgroups defined by gender, ethnicity, and timing of CR initiation. RESULTS: Significant improvements in both physical and mental HRQoL outcomes were associated with participation in CR (P < .001). Women and ethnic-minority patients presented with lower baseline HRQoL; however, they demonstrated greater relative improvements in physical and mental domains, respectively (P < .05 and P < .001). Despite these benefits, ethnic-minority patients exhibited lower adherence rates (P < .01). Early initiation of CR (≤90 days) was associated with superior baseline functional capacity, as reflected by greater six-minute walk test distances and higher metabolic equivalents. CONCLUSIONS: Women and ethnic-minority patients derive substantial HRQoL benefits from CR despite lower baseline status, yet remain less engaged in rehabilitation programs. These findings highlight a critical gap in secondary prevention and underscore the need for targeted, equity-oriented strategies to improve participation and maximize outcomes in high-benefit populations.