# WOMEN AND MEN PROFIT EQUALLY FROM CARDIAC REHABILITATION: A SECONDARY ANALYSIS OF THE OPTICARE RCT

## TL;DR

Women and men benefit similarly from cardiac rehabilitation, but each group faces unique challenges in meeting specific health targets.

## Contribution

This study provides evidence that cardiac rehabilitation benefits both sexes equally, but highlights the need for tailored programmes to address sex-specific challenges.

## Key findings

- Both women and men showed similar improvements in aerobic capacity, physical behavior, cardiovascular risk profile, and quality of life.
- Women improved more in depressive symptoms but struggled more with physical activity and anxiety targets.
- Men had more difficulty meeting aerobic capacity targets compared to women.

## Abstract

To explore sex-specific differences in cardiac rehabilitation (CR) outcomes.

Aerobic capacity (6-Minute Walk Test), physical behaviour (accelerometer), cardiovascular risk profile (weight, blood pressure, cholesterol), and psychosocial well-being (questionnaires) were measured in patients after an acute coronary syndrome (147 women, 642 men) at CR start and completion, and 18 months’ follow-up. Sex differences were studied using GEE models adjusted for age and differences in baseline characteristics. Additionally, whether men and women met targets associated with health risk reductions was assessed.

Both sexes experienced similar CR benefits. Only for depressive symptoms did women show larger improvements (HADS score; ♀: –2.7 vs ♂: –1.1; p = 0.017). Nevertheless, long-term follow-up revealed women still lagged in meeting targets for physical activity (♀: 76.5% vs ♂: 93.1%; p < 0.001) and anxiety symptoms (♀: 75.5% vs ♂: 86.8%; p < 0.001), while men lagged in meeting aerobic capacity targets (♀: 71.3% vs ♂: 58.8%; p < 0.001).

Women experience similar CR benefits to men in aerobic capacity, physical behaviour, cardiovascular risk profile, anxiety, and quality of life, with greater improvement in depressive symptoms. However, target values were less often met by women in physical behaviour and psychosocial well-being, and by men in aerobic capacity. Tailored CR programmes may be needed to address the unique needs of women and men.

This study investigated whether women and men benefit equally from cardiac rehabilitation. We followed 147 women and 642 men who participated in cardiac rehabilitation, measuring their aerobic fitness, cardiovascular health, and mental well-being at the start, end, and 18 months after the programme. Overall, both women and men showed similar improvements, with women experiencing greater improvements in depressive symptoms. Nevertheless, women continued to have more difficulties in meeting physical activity goals and were more affected by anxiety symptoms, while men were more often not meeting their aerobic fitness targets. These findings suggest that cardiac rehabilitation programmes may need to be adjusted to better address the specific needs of both women and men.