title: The benefits of cardiac rehabilitation in coronary heart disease: a gender issue?
abstract: OBJECTIVE
  Coronary heart disease is the leading cause of death in women worldwide and several studies have shown that they are under-represented in cardiac rehabilitation therapy. The objectives of this study were to assess the prevalence of women in a cardiac rehabilitation program and to assess their response to this intervention.
  
  
  METHODS
  This is a retrospective study of 858 patients who attended an exercise-based cardiac rehabilitation program after an acute coronary syndrome or elective percutaneous coronary intervention, between January 2008 and December 2012. The patients were analyzed by gender, and the impact of the intervention on cardiovascular risk factors and NT-proBNP was studied. In a subgroup of 386 patients the impact on functional capacity, resting heart rate, chronotropic index and heart rate recovery was also analyzed.
  
  
  RESULTS
  Only 24% of the 858 patients who attended the program were women. Women showed statistically significant improvements in all cardiovascular risk factors, NT-proBNP, functional capacity and heart rate recovery (p<0.05) after the program. There were also improvements in resting heart rate and chronotropic index, but these were not statistically significant (p=0.08 and p=0.40, respectively) and when the improvements in these two parameters were compared between genders, there was no statistically significant difference (p=0.33 and p=0.17, respectively).
  
  
  CONCLUSIONS
  Only 24% of the patients attending the program were women. We found that they benefited from cardiac rehabilitation therapy, with significant improvements in cardiovascular risk factors and in most of the prognostic markers studied.
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal. Electronic address: diana_anjo@hotmail.com.
authors: Diana
authors: D
authors: Anjo
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Mário
authors: M
authors: Santos
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Patrícia
authors: P
authors: Rodrigues
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Bruno
authors: B
authors: Brochado
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Maria João
authors: MJ
authors: Sousa
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Ana
authors: A
authors: Barreira
authors: Serviço de Medicina Física e de Reabilitação, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Sofia
authors: S
authors: Viamonte
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Preza
authors: P
authors: Fernandes
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: António Hipólito
authors: AH
authors: Reis
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: José
authors: J
authors: Lopes Gomes
authors: Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors: Severo
authors: S
authors: Torres
mesh_terms: D003324:Coronary Artery Disease / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016387:Women's Health / Q000706:statistics & numerical data*
keywords: Cardiac rehabilitation; Doença cardíaca isquémica; Ischemic heart disease; Mulheres; Reabilitação cardíaca; Women