Bouakkar J, Pereira T J, Johnston H, Pakosh M, Drake J D M, Edgell H
School of Kinesiology and Health Science, Bethune College, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
University Health Network, Toronto, ON, Canada.
BMC Sports Sci Med Rehabil. 2024 Mar 28;16(1):74. doi: 10.1186/s13102-024-00867-9.
Heart disease is one of the leading causes of death in Canada. Many heart disease patients are referred for cardiac rehabilitation, a multidisciplinary outpatient program often consisting of exercise training. Cardiac rehabilitation has been proven to be a successful secondary preventative measure in reducing mortality and improving overall health in heart disease patients, and its completion is important for both sexes as there is growing evidence that women benefit as much as men, if not more, with regard to mortality. It is important to note that previous studies have shown that healthy men and women respond differently to aerobic and resistance training, possibly due to hormones, body composition, autonomic and/or cardiovascular differences. However, evaluating sex differences in the efficacy of standard cardiac rehabilitation programs has not yet been fully explored with many studies investigating clinical or anthropometric data but not physiological outcomes. This systematic review aimed to investigate physiological differences in male and female heart disease patients after cardiac rehabilitation. The inclusion criteria were purposefully broad to encompass many cardiac rehabilitation scenarios, many cardiac disease states, and various program lengths and intensities with the intention of highlighting strengths and weaknesses of the current body of literature.
To conduct a synthesis without meta-analysis, a search strategy was generated to examine the relationships between heart disease patients, a supervised exercise program, physiological outcomes, and sex differences. The review was registered (Prospero: CRD42021251614) and the following databases were searched from inception to 19 December 2023: APA PsycInfo (Ovid), CINAHL Complete (EBSCOhost), Embase (Ovid), Emcare Nursing (Ovid), Medline All (Ovid; includes PubMed non-Medline), and Web of Science Core Collection. Eighty-eight studies pertaining to fitness, metabolism, body composition, respiratory function, cardiac function and C-reactive protein underwent data extraction.
Importantly, this review suggests that men and women respond similarly to a wide-range of cardiac rehabilitation programs in most physiological variables. However, many studies discussing maximal oxygen consumption, functional capacity, six-minute walk distances, and grip strength suggest that men benefit more. Further research is required to address certain limitations, such as appropriate statistical methods and type/intensity of exercise interventions.
心脏病是加拿大主要的死因之一。许多心脏病患者会被转介至心脏康复项目，这是一个多学科的门诊项目，通常包括运动训练。心脏康复已被证明是一项成功的二级预防措施，可降低心脏病患者的死亡率并改善其整体健康状况，而且完成该项目对男女两性都很重要，因为越来越多的证据表明，在死亡率方面，女性受益程度与男性相当，甚至可能更多。需要注意的是，先前的研究表明，健康的男性和女性对有氧训练和抗阻训练的反应不同，这可能是由于激素、身体成分、自主神经和/或心血管方面的差异。然而，评估标准心脏康复项目疗效中的性别差异尚未得到充分探讨，许多研究调查的是临床或人体测量数据，而非生理结果。本系统评价旨在调查心脏病患者在心脏康复后男性和女性之间的生理差异。纳入标准有意设定得较为宽泛，以涵盖多种心脏康复场景、多种心脏病状态以及不同的项目时长和强度，目的是突出当前文献的优点和不足。
为了进行无荟萃分析的综合分析，制定了一项检索策略，以研究心脏病患者、监督运动项目、生理结果和性别差异之间的关系。该评价已注册（国际系统评价前瞻性注册库：CRD42021251614），并检索了以下数据库自创建至2023年12月19日的数据：美国心理学会心理学文摘数据库（Ovid平台）、护理学与健康领域数据库（EBSCOhost平台）、荷兰医学文摘数据库（Ovid平台）、护理学与健康领域数据库（Ovid平台）、医学期刊数据库（Ovid平台；包括非医学期刊数据库的PubMed）以及科学引文索引核心合集。对88项关于体能、代谢、身体成分、呼吸功能、心脏功能和C反应蛋白的研究进行了数据提取。
重要的是，本评价表明，在大多数生理变量方面，男性和女性对广泛的心脏康复项目的反应相似。然而，许多关于最大摄氧量、功能能力、6分钟步行距离和握力的研究表明，男性受益更多。需要进一步研究以解决某些局限性，如适当的统计方法以及运动干预的类型/强度。
