Women and men profit equally from cardiac rehabilitation: a secondary analysis of the OPTICARE RCT

PURPOSE: To explore sex-specific differences in cardiac rehabilitation (CR) outcomes. METHODS: 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. RESULTS: 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). CONCLUSION: 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.