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Do women with cardiovascular disease respond differently to aerobic interval training? Exploring the interaction between sex and exercise modality on psychological and cardiomtabolic health

Session Poster Session 2

Speaker Tasuku Terada

Congress : ESC Preventive Cardiology (Formerly EuroPrevent) 2019

  • Topic : preventive cardiology
  • Sub-topic : Secondary Prevention
  • Session type : Poster Session
  • FP Number : P520

Authors : T Terada (Ottawa,CA), R Beanlands (London,CA), HE Tulloch (Ottawa,CA), AL Pipe (Ottawa,CA), D Chirico (Ottawa,CA), JL Reed (Ottawa,CA)

T Terada1 , R Beanlands2 , HE Tulloch1 , AL Pipe1 , D Chirico1 , JL Reed1 , 1University of Ottawa Heart Institute, Division of Prevention and Rehabilitation - Ottawa - Canada , 2University of Western Ontario, Medicine - London - Canada ,


Background/Introduction: Cardiovascular disease (CVD) is a global pandemic and the leading cause of morbidity and mortality in women. Following cardiovascular events, women suffer from more adverse psychological and cardiometabolic heath when compared to men, leading to poorer prognosis. Cardiac rehabilitation (CR) affords significant opportunities to lower cardiovascular morbidity and mortality by improving psychological and cardiometabolic health. However, fewer women than men participate in CR programs partly due to greater time constraints and less interest in conventional moderate-intensity continuous exercise (MICE) programming. Aerobic interval training (AIT) has emerged as an alternative time-efficient effective approach to improve risk factors of secondary events in women. It is currently unknown whether AIT is equally effective in women and men.

Purposes: To investigate if the effects of AIT on psychological and cardiometabolic health were influenced by sex.

Methods: We analyzed the records of 120 patients (60 women and 60 men) with CVD who attended a 10-week, twice weekly outpatient CR program. Depression and anxiety were assessed using the hospital anxiety and depression scale (HADS), and cardiometabolic heath indicators (i.e., body mass, body mass index [BMI], waist circumference, resting blood pressure and heart rate [HR]) were measured using standardized procedures at baseline and following CR. A 2x2 ANCOVA (i.e., women vs. men by AIT vs. MICE) was performed to examine the changes in anxiety, depression and cardiometabolic health indicators, with a primary interest in the sex-by-exercise modality interaction effect. Analyses were adjusted for baseline age, body mass, CR session attendance, and concomitant cardiac conditions.

Results: Sixty participants (30 women and 30 men) completed AIT and another 60 participants (30 women and 30 men) completed MICE. At baseline, men had greater body mass and waist circumference (both p<0.01). The CR session attendance rates did not differ between women and men or between AIT and MICE. Both AIT and MICE improved anxiety, depression, body mass, BMI and waist circumference significantly in women and men (all p<0.05). The sex-by-exercise modality interaction effect on anxiety severity was significant (p=0.035), revealing a greater reduction in women following AIT compared to MICE (-1.7 ± 3.5 vs. -1.1 ± 3.0 points), but a greater reduction in men following MICE compared to AIT (-3.3 ± 2.5 vs. -1.5 ± 2.9 points). Sex did not have significant effects on depression or cardiometabolic measures.

Conclusions: AIT is an alternative exercise modality in CR settings to improve psychological and cardiometabolic health of women and men. However, the improvement in anxiety severity met clinical significance (i.e., =1.7 points) only following AIT in women and only following MICE in men. These findings underscore that CR interventions tailored to sex have the potential to augment the effectiveness of CR.

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