Predictors of gain in exercise capacity through cardiac rehabilitation: Sex and age matter

Last updated on August 25, 2023 First published on August 24, 2023

Background: Cardiac rehabilitation (CR) is a cornerstone of secondary prevention that improves cardiovascular outcomes. However, the determinants of treatment success are poorly understood.

Objectives: We investigated the associations of health-related quality of life (HRQoL), sex, age, employment status and housing situation with improvement in exercise capacity throughout CR.

Cardiovascular diseases (CVD) are a major public health burden. Cardiac rehabilitation (CR) has become a cornerstone of secondary cardiovascular prevention worldwide and improves cardiovascular outcomes. The determinants affecting treatment outcome of CR, however, are poorly understood. Awareness of the impact of sex on the course of cardiovascular disease and treatment has increased. Research shows a notable under representation of women in cardiovascular clinical trials, raising concerns of a bias in research and its ensuing guidelines and therapeutic interventions towards favoring men. In secondary prevention, sex differences have been reported, pointing at lower referral and adherence rates, as well as completion of CR in women.
Evidence on sex differences in exercise capacity improvement is conflicting, with female sex being associated with smaller or equal exercise capacity improvement during outpatient CR. As to the investigation of age in CR, only one study of post-percutaneous coronary intervention (pPCI) patients has reported age-related improvement in exercise capacity during outpatient CR, with greater improvement in younger participants.

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