Women Have Lower Mortality Than Men After Attending a Long-Term Medically Supervised Exercise Program

Area of Science:

• Cardiology
• Exercise Physiology
• Public Health

Background:

• Cardiovascular disease (CVD) affects both men and women, with women historically exhibiting lower mortality rates.
• Medically supervised exercise programs (MSEPs) are crucial for CVD management in both sexes.
• Understanding sex-based differences in MSEP outcomes is vital for personalized patient care.

Purpose of the Study:

• To investigate whether women with CVD experience superior survival rates compared to men within a medically supervised exercise program (MSEP).
• To test the hypothesis that women attending MSEPs have better long-term survival outcomes than men.
• To analyze sex-specific survival differences in CVD patients undergoing structured exercise rehabilitation.

Main Methods:

• Retrospective analysis of data from 2236 men and women enrolled in an MSEP between 1994 and 2018.
• Inclusion of aerobic, resistance, flexibility, and balance exercises, with cardiopulmonary exercise testing.
• Survival analysis using Kaplan-Meier methods and Cox proportional hazards regression.

Main Results:

• Cardiovascular disease was the leading cause of death (39%) in both sexes.
• Women demonstrated a more favorable clinical profile and significantly longer survival compared to men (HR = 0.71).
• Even after adjusting for baseline cardiorespiratory fitness and age, women with coronary artery disease showed better long-term survival (HR = 0.68).

Conclusions:

• Long-term survival following participation in an MSEP is better for women than for men.
• This survival benefit in women was observed despite their lower baseline cardiorespiratory fitness.
• Further research is needed to elucidate the mechanisms behind these sex-based differences and to confirm similar benefits for men and women in MSEPs.