Characteristics and outcomes of women undergoing a cardiac rehabilitation program

Despite its recommendation, only 20-40% of eligible patients undergo Cardiac Rehabilitation programs. This percentage is even lower among women.

The aim of this study was to analyze the characteristics of women undergoing a Cardiac Rehabilitation program in a tertiary hospital, their outcomes, and a comparison with men.

A total of 430 patients who participated in the program at our center in 2022 and 2023 were included. Clinical characteristics and lipid parameters were recorded at admission, at the first post-discharge analysis, and upon completion of the program. Outcome indicators were assessed using the chi-square method to estimate differences in qualitative variables and Student's t-test in quantitative variables.

The mean age of the group was 58±9 years. The group consisted of 78% men, 29% diabetics, 52% smokers, 41% with early ischemic heart disease, and 31.4% with obesity (BMI > 30). There was a higher percentage of coronary syndrome in men (94% vs. 79%) and a lower percentage of heart failure (8% vs. 3%, p=0.000).

The quality of life questionnaire scored lower in women (48±21 vs. 56±22, p=0.005), and functional capacity was worse (6.9±3 METs vs. 8.7±3 METs, p=0.000). There were more women with normal weight (18% vs. 30%, p=0.04), although the rates of obesity were similar (30% vs. 32%).

The baseline lipid profile was more favorable in women, with a lower percentage of elevated triglycerides (TG) (20% vs. 37%, p=0.004), elevated remnant levels (20.5% vs. 36%, p=0.011), and a high TG/HDL ratio (2.8 vs. 4.05, p=0.002). However, lipoprotein (a) [Lp(a)] levels were higher in women (71 vs. 35 mg/dL, p=0.003).

There were no significant differences in changes in quality of life, functional capacity, and weight. The proportion of patients achieving target parameters was similar. The lipid profile improved more in men, with greater changes in TG, TG/HDL, and remnants, although they had higher LDL cholesterol levels (62 vs. 54 mg/dL, p=0.000).

The percentage of women participating in Cardiac Rehabilitation programs in our environment is still low, at 22%. Clinical indications differ, and women have worse quality of life and functional capacity. However, they achieve similar improvements to men. The lipid profile is different, with a lower prevalence of triglyceride-rich particles and a higher prevalence of elevated Lp(a). The implication of this profile in the etiology of heart disease in women need to be explored in larger studies.

Baseline lipid profile