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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Gender differences in home-based cardiac rehabilitation of post-percutaneous coronary intervention patients
1Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, Republic of Korea.
Insights
This 9-month home-based cardiac rehabilitation program showed improved fitness and HDL-C in men post-PCI. Women experienced benefits in specific exercises like the 6-minute walk, but overall risk factor improvements were limited.
Area of Science:
- Cardiology
- Preventive Medicine
- Exercise Physiology
Background:
- Cardiac rehabilitation (CR) is crucial for secondary cardiovascular disease (CVD) prevention.
- Home-based CR programs offer accessible options for post-percutaneous coronary intervention (PCI) patients.
- Understanding gender-specific responses to CR is vital for optimizing patient outcomes.
Purpose of the Study:
- To investigate gender differences in outcomes following a 9-month home-based cardiac rehabilitation program.
- To assess the impact of CR on anthropometric, lipid profiles, and fitness variables in male and female post-PCI patients.
- To compare participation and dropout rates between genders in a home-based CR setting.
Main Methods:
- A 9-month home-based CR program involving exercise and nutrition counseling was implemented.
- Participants (men and women) post-PCI underwent initial, 4-month, and 9-month assessments.
- Exercise protocols focused on target heart rate zones, while nutrition involved low-salt, low-cholesterol diets.
Main Results:
- No significant gender difference in dropout rates was observed.
- Men showed significant increases in HDL-cholesterol (HDL-C) and improvements in cardiorespiratory endurance, strength, and agility.
- Women did not exhibit significant changes in most risk factors or fitness variables, though 6-minute walk and timed up and go tests showed effectiveness.
Conclusions:
- The 9-month home-based CR program demonstrated greater effectiveness in improving fitness parameters for men.
- While HDL-C improved in men, other cardiovascular risk factors showed limited changes across genders.
- Specific exercises like the 6-minute walk and timed up and go were beneficial for women's functional capacity.
Abstract:
Cardiac rehabilitation (CR) is a structured program for the prevention of secondary cardiovascular disease (CVD) and related diseases, such as hypertension, diabetes, and obesity. This study aimed to investigate whether there are gender differences after 9 months of home-based cardiac rehabilitation program in post-percutaneous coronary intervention patients. A total of 114 (58.29 ± 10.33 years) men and 30 (60.90 ± 9.32 years) women were enrolled in the CR program. The program included three visits: initial, 4th month (follow-up), and 9th month (final) visits at a CR center. The CR program included exercise and nutrition counseling. In nutrition counseling, a professional nutritionist educated the patients on how to organize the menu, incorporating an optimal caloric, low-salt, and low-cholesterol diet. Exercise was performed 30 min per session for more than 3 days per week with a target heart rate within 40-75% of the peak heart rate-resting heart rate (VO2 reserve; VO2R) during intense exercise, which was based on ECG treadmill test. After 9 months, there was no significant difference in terms of dropout rate between men and women (p < 0.05). No significant changes were found in the anthropometric and lipid profiles in women, whereas the HDL-cholesterol (HDL-C) was significantly increased to 6.8% (p = 0.005) in men. The findings of our study showed that there was no difference in the CR participation rate between men and women. Moreover, there was an increase in HDL-C levels and an improvement in cardiorespiratory endurance, strength, and agility in men, whereas no significant difference in most risk factors and fitness variables was found in women. Thus, the 9-month home-based CR program was more effective for fitness in men, but only the HDL-C showed positive improvement among the cardiovascular risk factors. In women, 6-min walk and timed up and go were effective exercises.
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