Gee Michael A, Viera Anthony J, Miller Paula F, Tolleson-Rinehart Sue
School of Public Health, University of North Carolina, Chapel Hill.
J Cardiopulm Rehabil Prev. 2014 Jul-Aug;34(4):255-62. doi: 10.1097/HCR.0000000000000066.
Cardiac rehabilitation (CR) has been shown to generally increase functional capacity and lower cardiovascular morbidity in patients with ischemic heart disease. The effectiveness of CR in female participants, however, is unclear. We thus examined whether improvement in functional capacity after CR differs between men and women with ischemic heart disease.
Our study was a retrospective cohort study that included 1104 participants (346 women and 758 men) enrolled in CR from 2002 through 2011. We measured change in metabolic equivalents (METs) after CR to assess improvement in functional capacity in male and female participants. We considered various potential confounders, including baseline METs, CR referral indication, age, race, body mass index, baseline cholesterol, and home zip code average prosperity.
Men experienced a greater improvement in METs following CR in all models, including the unadjusted model (2.16 METs in men, 1.65 METs in women; P = .0001), the model adjusting for CR indication only (2.15 METs in men, 1.67 METs in women; P = .0003), and the model adjusting for age, body mass index, and CR indication (2.12 METs in men, 1.66 METs in women; P = .0004).
We show that men obtain greater benefit from current CR programs than do women. This implies that tailoring CR programs to women may yield further improvement in functional capacity for female CR participants.
心脏康复(CR)已被证明通常可提高缺血性心脏病患者的功能能力并降低心血管疾病发病率。然而,CR对女性参与者的有效性尚不清楚。因此,我们研究了缺血性心脏病患者中,男性和女性在CR后功能能力的改善是否存在差异。
我们的研究是一项回顾性队列研究,纳入了2002年至2011年期间参加CR的1104名参与者(346名女性和758名男性)。我们测量了CR后代谢当量(METs)的变化,以评估男性和女性参与者功能能力的改善情况。我们考虑了各种潜在的混杂因素,包括基线METs、CR转诊指征、年龄、种族、体重指数、基线胆固醇和家庭邮政编码地区的平均富裕程度。
在所有模型中,男性在CR后METs的改善更大,包括未调整模型(男性为2.16 METs,女性为1.65 METs;P = 0.0001)、仅调整CR指征的模型(男性为2.15 METs,女性为1.67 METs;P = 0.0003)以及调整年龄、体重指数和CR指征的模型(男性为2.12 METs,女性为1.66 METs;P = 0.0004)。
我们表明,与女性相比,男性从当前的CR计划中获得的益处更大。这意味着针对女性量身定制CR计划可能会进一步提高女性CR参与者的功能能力。