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Closing the gap: sex-based differences in benefits and participation in cardiac rehabilitation
Session:
Sessão de Posters 36 - Reabilitação para todos: equidade, inovação e impacto a longo prazo
Speaker:
Ana Rita Andrade
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Ana Rita Andrade; Diogo Ferreira; Graça Araújo; José Costa; Inês Aguiar-Ricardo; Pedro Alves da Silva; Nelson Cunha; Fausto J. Pinto; Ana Abreu
Abstract
<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Introduction: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Although women benefit from cardiac rehabilitation (CR) as much as or more than men, significant gaps in access, participation, and outcomes remain an issue. Addressing these disparities requires increased awareness and the adoption of targeted, women-centered strategies in CR.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Purpose: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">This study aims to examine how sex impacts adherence and physiological response in cardiac rehabilitation.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Prospective observational single-center study including patients enrolled in a phase II CR program between 2015 and 2025. The program involved assessments by cardiologists, nutritionists and psychologists, with exercise sessions twice a week. Clinical, laboratory, echocardiographic and CPET data were collected.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Results: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Among 695 patients, 20% were women (n = 140). Age was similar between sexes (p = 0.255), and the prevalence of major comorbidities—including ischemic cardiomyopathy, hypertension, diabetes, and dyslipidemia—did not differ, except for a higher prevalence of smoking history among men (OR 1.78). Women showed slightly lower adherence to the rehabilitation program compared with men (median 92.3% [77.8–100] vs. 93.8% [83.3–100]; p = 0.04), with adherence defined as the ratio of completed to scheduled sessions.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">As presented in Table 1, both sexes experienced significant improvements across multiple CPET parameters following cardiac rehabilitation, including peak VO2 (pVO2), percentage of predicted pVO2, VO2 at the first and second thresholds, peak PETCO2, VE/VCO2 slope, and peak workload. Despite lower program adherence, women demonstrated similar gains to men in all measures, except for the percentage of predicted VO2 peak, which was higher in female patients (p = 0.013).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> </span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Conclusions: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Even with slightly lower participation, women achieved exercise and functional gains equivalent to men, underscoring the effectiveness of cardiac rehabilitation in both sexes</span></span></span></p>
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