Effect of gender difference on the compliance to cardiac rehabilitation program and risk factor reduction

Abstract

Cardiac rehabilitation and exercise training have beneficial effects on cardiovascular disease (CVD) risk factors such as improving plasma lipids, insulin sensitivity, exercise capacity, and lowering mortality, most of studies found a significant reduction in risk factors among active coronary artery disease (CAD) patients compared to sedentary patients. The purpose of present study was done to examine the effect of differences between men and women with ischemic heart disease that enrolled in cardiac rehabilitation program in their compliance and risk factor reduction. The study was conducted on 60 patients recruited in the period between May-2015 to May-2016, from the cardiac rehabilitation clinic in the cardiology department- Ain Shams University Hospital. All study subjects were enrolled in cardiac rehabilitation program for three months twice weekly. All patients were subjected to full history taking and physical examinations, body mass index (BMI) calculations, lipid profile (total cholesterol, TG, HDL, LDL), fasting blood sugar (HbA1c), trans-thoracic Echocardiography, functional capacity obtained from exercise stress test. All above data were taken before and after three months of CRP. The study patients were divided into two groups according to Gender; male group (30 patients) and female group (30 patients).

Gender Differences that exist at baseline: • Female group had longer time up to enrollment in CRP and less likely to be compliant to the number of session in CRP, they were more diabetic and hypertensive also had a higher BMI, waist circumference, and higher HbA1c than male group. • Male group were more smoker, had more employment and were more diagnosed with Myocardial infarction, and had higher LV EDD compared with female group. • There was no difference between Male and Female group in Age, Marital status, Educational level, Family history of IHD, NYHA-Class, Blood pressure, and Heart Rate, LV EF, LV ESD, and lipid profile (TC, TG, LDL, HDL). At the end of CRP: • In our whole cohort there was a significant improvement in: smoking secession, BMI, Waist-circumference, NYHA-Class, systolic and diastolic blood pressure, lipid profile (TC, TG, LDL, HDL), HbA1c, LV EF and LV ESD at the end of CRP Gender Differences that exist at the end of CRP: • Female group still have a higher BMI and Waist-circumference than males. • Male group still have higher LV EDD. So, the present study found that involvement of patients in cardiac rehabilitation program improve their risk factors, NYHA Class, Lipid profile and Echocardiographic parameters and hence Cardiac Rehabilitation Program should be implemented in routine management of patients with coronary artery disease.