Female sex was associated with slightly lower adherence to cardiac rehabilitation than male sex (median 92.3% vs 93.8%; p=0.04), but women achieved equivalent or greater functional gains.
Observational (n=695)
No
Does sex impact adherence and physiological response in patients undergoing cardiac rehabilitation?
Despite slightly lower program adherence, women achieve equivalent or greater functional and physiological gains from cardiac rehabilitation compared to men.
Absolute Event Rate: 92.3% vs 93.8%
p-value: p=0.04
Abstract Introduction Although women benefit from cardiac rehabilitation (CR) as much as or more than men, significant gaps in access, participation, and outcomes remain an issue. Addressing these disparities requires increased awareness and the adoption of targeted, women-centered strategies in CR. Purpose This study aims to examine how sex impacts adherence and physiological response in cardiac rehabilitation. Methods Prospective observational single-center study including patients enrolled in a phase II CR program between 2015 and 2025. The program involved assessments by cardiologists, nutritionists and psychologists, with exercise sessions twice a week. Clinical, laboratory, echocardiographic and CPET data were collected. Results Among 695 patients, 20% were women (n = 140). Age was similar between sexes (p = 0.255), and the prevalence of major comorbidities—including ischemic cardiomyopathy, hypertension, diabetes, and dyslipidemia—did not differ, except for a higher prevalence of smoking history among men (OR 1.78). Women showed slightly lower adherence to the rehabilitation program compared with men (median 92.3% 77.8–100 vs. 93.8% 83.3–100; p = 0.04), with adherence defined as the ratio of completed to scheduled sessions. As presented in Table 1, both sexes experienced significant improvements across multiple CPET parameters following cardiac rehabilitation, including peak VO2 (pVO2), percentage of predicted pVO2, VO2 at the first and second thresholds, peak PETCO2, VE/VCO2 slope, and peak workload. Despite lower program adherence, women demonstrated similar gains to men in all measures, except for the percentage of predicted VO2 peak, which was higher in female patients (p = 0.013). Conclusions Even with slightly lower participation, women achieved exercise and functional gains equivalent to men, underscoring the effectiveness of cardiac rehabilitation in both sexes.For image description, please refer to the figure legend and surrounding text.
Esteves et al. (Mon,) conducted a observational in Cardiac rehabilitation (n=695). Female sex vs. Male sex was evaluated on Adherence to the rehabilitation program (p=0.04). Female sex was associated with slightly lower adherence to cardiac rehabilitation than male sex (median 92.3% vs 93.8%; p=0.04), but women achieved equivalent or greater functional gains.