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.