Cardiac rehabilitation in women, challenges and opportunities

Area of Science:

• Cardiology
• Preventive Medicine
• Women's Health

Background:

• Cardiac rehabilitation (CR) offers proven benefits for cardiovascular disease (CVD) patients, including reduced mortality, improved quality of life (QoL), and fewer readmissions.
• Despite established benefits, CR utilization remains significantly lower in women compared to men, indicating disparities in referral, enrollment, and completion.
• Specific CVD conditions more prevalent in women, such as postpartum cardiomyopathy and Spontaneous Coronary Artery Dissection (SCAD), require further understanding regarding CR's efficacy.

Purpose of the Study:

• To review the specific benefits of cardiac rehabilitation (CR) for various female populations.
• To identify and elucidate the barriers hindering women's participation in CR programs.
• To outline current recommendations and strategies for overcoming these barriers and improving CR access for women.

Main Methods:

• Literature review of existing studies on cardiac rehabilitation (CR) in women.
• Analysis of disparities in CR referral, enrollment, and completion rates between genders.
• Synthesis of evidence on CR benefits for female-specific cardiovascular conditions.
• Identification of barriers through review of clinical practice and patient-reported data.
• Compilation of expert recommendations and proposed interventions.

Main Results:

• CR demonstrates significant benefits in reducing CVD mortality, enhancing QoL, and preventing readmissions across patient populations.
• Substantial disparities persist, with women experiencing lower rates of CR referral, enrollment, and program completion compared to men.
• The utility of CR for female-predominant CVDs like postpartum cardiomyopathy and SCAD warrants further investigation and tailored approaches.
• Key barriers include lack of awareness, physician bias, logistical challenges, and program design not accounting for women's needs.
• Recommendations focus on enhanced physician education, targeted patient outreach, flexible program scheduling, and addressing psychosocial factors.

Conclusions:

• Cardiac rehabilitation (CR) is crucial for women's cardiovascular health, yet significant utilization gaps exist.
• Addressing identified barriers through targeted strategies is essential to improve equitable access to CR for women.
• Further research is needed to optimize CR protocols for female-specific cardiovascular conditions to maximize benefits.