Marra Alberto M, Giardino Federica, Salzano Andrea, Caruso Roberto, Parato Vito Maurizio, Diaferia Giuseppe, Pagliani Leopoldo, Miserrafiti Bruna, Gabriele Michele, Mallardo Mario, Bifulco Giuseppe, Zampella Angela, Franzone Anna, Esposito Giovanni, Bossone Eduardo, Raparelli Valeria, Cittadini Antonio
Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
Interdepartmental Center for Research in Gender Medicine-GENESIS, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
Eur Heart J Open. 2024 Sep 6;4(5):oeae071. doi: 10.1093/ehjopen/oeae071. eCollection 2024 Sep.
Notwithstanding its acknowledged pivotal role for cardiovascular prevention, cardiac rehabilitation (CR) is still largely under prescribed, in almost 25% of patients owing an indication for. In addition, when considering differences concerning the two sexes, female individuals are underrepresented in CR programmes with lower referral rates, participation, and completion as compared to male counterpart. This picture becomes even more tangled with reference to gender, a complex socio-cultural construct characterized by four domains (gender identity, relation, role, and institutionalized gender). Indeed, each of them reveals several obstacles that considerably penalize CR adherence for different categories of people, especially those who are not identifiable with a non-binary gender. Aim of the present review is to identify the sex- (i.e. biological) and gender- (i.e. socio-cultural) specific obstacles to CR related to biological sex and sociocultural gender and then envision a likely viable solution through tailored treatments towards patients' well-being.
尽管心脏康复（CR）在心血管预防方面的关键作用已得到认可，但在几乎25%有适应症的患者中，其处方量仍然严重不足。此外，考虑到两性之间的差异，与男性相比，女性在心脏康复项目中的代表性不足，转诊率、参与率和完成率较低。关于性别这一复杂的社会文化概念（由四个领域构成：性别认同、关系、角色和制度化性别），情况变得更加复杂。事实上，其中每一个领域都揭示了一些障碍，这些障碍严重影响了不同类别人群对心脏康复的依从性，尤其是那些无法认同非二元性别的人。本综述的目的是确定与生物性别和社会文化性别相关的心脏康复的性别（即生物学）和社会性别（即社会文化）特定障碍，然后通过针对患者福祉的个性化治疗设想一种可能可行的解决方案。
