Current programs of cardiac rehabilitation (CR) typically provide a standardized approach to all patients. We examined whether CR would produce similar improvements in psychosocial and cardiometabolic health indicators in women compared with men. The records of patients who completed a 3-month outpatient CR program were examined. We compared health-related quality of life (i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS) scores), anxiety, depression, and cardiometabolic health indicators between women and men completing CR. Of the 591 participants who completed CR, 155 (26.2%) were women and 436 (73.8%) were men. At baseline, women were older (64 ± 9 vs. 62 ± 9 years, p = 0.045), had lower PCS (39.5 ± 8.1 vs. 43.9 ± 7.8 points, p < 0.001), and MCS (46.6 ± 10.8 vs. 49.4 ± 9.8 points, p = 0.003) scores, experienced elevated levels of anxiety (6.4 ± 4.0 vs. 5.2 ± 4.0 points, p = 0.001) and depression (4.7 ± 3.5 vs. 3.6 ± 3.3 points, p = 0.001), and had higher low-density lipoprotein cholesterol (2.1 ± 0.9 vs. 1.7 ± 0.7 mmol/L, p < 0.001) and high-density lipoprotein cholesterol (1.4 ± 0.4 vs. 1.1 ± 0.3 mmol/L, p < 0.001) concentrations when compared with men. Following CR, women showed smaller improvements in percent body mass (+1.1% ± 10.1% vs. −2.1% ± 9.7%, p = 0.002) and PCS scores (3.0 ± 8.1 vs. 6.3 ± 7.5 points, p < 0.001) when compared with men. Considering poorer psychosocial health at baseline and smaller improvements in health-related quality of life in women when compared with men, more specific CR strategies addressing the particular needs of women are required to improve their health status and reduce the risk of secondary cardiac events.

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Background Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination. Objectives This narrative review aimed to: (a) summarize women’s barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs. Methods Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function. Results Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women’s cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants’ needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions. Conclusion Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.

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