Cardiovascular rehabilitation programs have proven to be highly beneficial in improving health outcomes for individuals who have experienced heart failure, heart attack, heart surgery, or angioplasty. However, a recent study published in The Canadian Journal of Cardiology highlights that women are not reaping the same benefits from these programs as men. The study reveals that women face numerous barriers that prevent them from attending these programs, which can significantly reduce death and re-hospitalization rates.
Led by Dr. Sherry Grace, the study emphasizes that women encounter structural barriers at various levels, from the individual to the health system. The researchers developed the Cardiac Rehab Barriers Scale (CRBS) to better understand and assess these obstacles. Despite the remarkable benefits that participation in cardiac rehab offers, women continue to face challenges that limit their access to these programs.
Cardiovascular rehabilitation programs involve medically supervised exercises, stress reduction counseling, and education on heart-healthy living. They have been proven to be the most beneficial intervention for individuals with symptomatic heart disease, surpassing medications and procedural interventions. These programs monitor heart rate, blood pressure, heart rhythm, and symptoms while adapting the exercise program to meet the needs of each patient. They empower patients to take charge of their cardiovascular health and prioritize their heart health.
The recent study is the first of its kind to examine the barriers faced by both men and women in accessing cardiovascular rehabilitation programs. Conducted in 16 countries with over 2,000 participants, the research found that both men and women encounter significant barriers to utilizing these programs. However, women in the Americas, Western Pacific, and South East Asia bear a greater burden of barriers compared to men.
The study identified several barriers faced by women who have not yet enrolled in a cardiovascular rehabilitation program. These include a lack of awareness about the existence of such programs, failure of programs to contact women after referral, program cost, and discomfort or fatigue experienced during exercise. Women already enrolled in a program face additional barriers such as family responsibilities, travel, distance to facilities, and transportation difficulties.
Dr. Helga Van Herle, a cardiologist with Keck Medicine of USC, emphasizes the importance of women advocating for their cardiovascular health. Women often prioritize the well-being of others over their own, but it is crucial for them to be proactive and inquire about cardiac rehab programs, especially if they fall into a category that would benefit from these programs.
To address these barriers, the study provided participants with potential mitigation strategies. These include home-based programs or having discussions with healthcare providers. The majority of women rated this information as helpful or very helpful. Open communication between women and their healthcare providers is essential to overcome challenges and modify the program to suit individual needs.
Cardiovascular rehabilitation programs typically run for three months but can range from two to eight months. Attending 36 sessions can lower the risk of death by 47% and the risk of heart attack by 31% compared to attending only one session. Despite heart disease being the leading cause of death for women in the United States, women are still under-referred to cardiac rehabilitation programs. Black women are particularly disadvantaged, being 60% less likely than white women to be referred to or enroll in these programs.
Dr. Shannon Hoos-Thompson, a cardiologist at The University of Kansas Health System, emphasizes that this under-referral is indicative of a broader problem in the management of female cardiovascular health. To address this issue, it is crucial to raise awareness, identify women at risk, and ensure adequate treatment and support for women with heart conditions.
Cardiovascular rehabilitation programs have the potential to reduce death from all causes by 15% at one-year follow-up and by 45% at 15 years follow-up. They can also significantly lower mortality rates from cardiovascular disease by 30%. Encouraging greater female attendance in these programs can have a significant impact on the health outcomes of women worldwide. With millions of women living with heart disease and hundreds of thousands dying annually, it is imperative to address the barriers women face and promote equal access to cardiac rehab programs.