Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
Appl Physiol Nutr Metab. 2019 Nov;44(11):1237-1245. doi: 10.1139/apnm-2018-0876. Epub 2019 Apr 8.
Current programs of cardiac rehabilitation (CR) typically provide a standardized approach to all patients. We examined whether CR would produce similar improvements in psychosocial and cardiometabolic health indicators in women compared with men. The records of patients who completed a 3-month outpatient CR program were examined. We compared health-related quality of life (i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS) scores), anxiety, depression, and cardiometabolic health indicators between women and men completing CR. Of the 591 participants who completed CR, 155 (26.2%) were women and 436 (73.8%) were men. At baseline, women were older (64 ± 9 vs. 62 ± 9 years, = 0.045), had lower PCS (39.5 ± 8.1 vs. 43.9 ± 7.8 points, < 0.001), and MCS (46.6 ± 10.8 vs. 49.4 ± 9.8 points, = 0.003) scores, experienced elevated levels of anxiety (6.4 ± 4.0 vs. 5.2 ± 4.0 points, = 0.001) and depression (4.7 ± 3.5 vs. 3.6 ± 3.3 points, = 0.001), and had higher low-density lipoprotein cholesterol (2.1 ± 0.9 vs. 1.7 ± 0.7 mmol/L, < 0.001) and high-density lipoprotein cholesterol (1.4 ± 0.4 vs. 1.1 ± 0.3 mmol/L, < 0.001) concentrations when compared with men. Following CR, women showed smaller improvements in percent body mass (+1.1% ± 10.1% vs. -2.1% ± 9.7%, = 0.002) and PCS scores (3.0 ± 8.1 vs. 6.3 ± 7.5 points, < 0.001) when compared with men. Considering poorer psychosocial health at baseline and smaller improvements in health-related quality of life in women when compared with men, more specific CR strategies addressing the particular needs of women are required to improve their health status and reduce the risk of secondary cardiac events.
目前的心脏康复(CR)计划通常为所有患者提供标准化的方法。我们研究了 CR 是否会在女性和男性中产生类似的改善心理社会和心血管代谢健康指标的效果。检查了完成 3 个月门诊 CR 计划的患者的记录。我们比较了健康相关的生活质量(即,物理成分摘要(PCS)和心理成分摘要(MCS)评分)、焦虑、抑郁和心血管代谢健康指标,这些指标在完成 CR 的女性和男性之间进行了比较。在 591 名完成 CR 的参与者中,有 155 名(26.2%)是女性,436 名(73.8%)是男性。在基线时,女性年龄较大(64 ± 9 岁 vs. 62 ± 9 岁,= 0.045),PCS(39.5 ± 8.1 分 vs. 43.9 ± 7.8 分,< 0.001)和 MCS(46.6 ± 10.8 分 vs. 49.4 ± 9.8 分,< 0.001)评分较低,焦虑水平较高(6.4 ± 4.0 分 vs. 5.2 ± 4.0 分,< 0.001)和抑郁(4.7 ± 3.5 分 vs. 3.6 ± 3.3 分,< 0.001),低密度脂蛋白胆固醇(2.1 ± 0.9 毫摩尔/升 vs. 1.7 ± 0.7 毫摩尔/升,< 0.001)和高密度脂蛋白胆固醇(1.4 ± 0.4 毫摩尔/升 vs. 1.1 ± 0.3 毫摩尔/升,< 0.001)浓度高于男性。与男性相比,女性在体重百分比(+1.1%±10.1% vs. -2.1%±9.7%,= 0.002)和 PCS 评分(3.0±8.1 分 vs. 6.3±7.5 分,< 0.001)方面的改善较小。考虑到女性在基线时的心理社会健康状况较差,以及在生活质量方面的改善较小,需要制定更具体的 CR 策略来满足女性的特殊需求,以改善她们的健康状况并降低二次心脏事件的风险。