Referral patterns and exercise response in the rehabilitation of female coronary patients aged ≥62 years

https://doi.org/10.1016/0002-9149(92)90894-5Get rights and content

Abstract

Gender-related differences in cardiac rehabilitation referral patterns and response to an aerobic conditioning program were examined in 226 hospitalized older coronary patients (aged ≥62 years). Overall, the outpatient cardiac rehabilitation participation rate in this population was 21%. Older women were less likely to enter cardiac rehabilitation than were older men (15 vs 25%; p = 0.06), despite similar clinical profiles. This was explained primarily by a greater likelihood of primary physicians to strongly recommend cardiac rehabilitation to men. Before conditioning, women who entered cardiac rehabilitation were less fit than were men; peak oxygen consumption was 18% lower in women (16 ± 5 vs 20 ± 5 ml/kg/min; p = 0.02). However, both groups improved aerobic capacity similarly in response to a 12-week aerobic conditioning program, with maximal oxygen consumption increasing by 17% in women and by 19% in men. Thus, older female coronary patients are less likely to be referred for cardiac rehabilitation, despite a similar clinical profile and improvement in functional capacity from the training component.

References (22)

  • RM Steingart et al.

    Sex differences in the management of coronary artery disease

    N Engl J Med

    (1991)
  • Cited by (305)

    • Referral and participation in cardiac rehabilitation of patients following acute coronary syndrome; lessons learned

      2021, IJC Heart and Vasculature
      Citation Excerpt :

      As data on the reason for nonreferral is absent due to the retrospective nature of the study, this remains unknown. However, as previous studies concluded that physician’s perceived benefit and endorsement of cardiac rehabilitation is an important predictor of CR referral and attendance, increased physician awareness and education about the benefits of CR may improve CR participation [10,26–29]. A consistent finding in literature is that patients diagnosed with STEMI are more likely to be referred for CR as compared to patients with NSTEMI and, especially, unstable angina [7,8,10].

    • Cardiac Rehabilitation for Women: A Systematic Review of Barriers and Solutions

      2017, Mayo Clinic Proceedings
      Citation Excerpt :

      A summary of the risk of bias of the included studies is presented in Supplemental Appendix 2 and Supplemental Figure 2, available online at http://www.mayoclinicproceedings.org. We identified 24 studies related to barriers on CR participation in women.18,27,34-55 Table 1 lists the patient-, provider-, and social/environmental-level factors that were identified, including those that are nonmodifiable (eg, age and diagnosis) and potentially modifiable (eg, transportation barriers).

    View all citing articles on Scopus
    1

    Dr. Ades was supported by Clinical Investigator Award 1 K08 AG00426-01 from the National Institute on Aging, Bethesda, Maryland.

    View full text