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Gender approach in cardiac rehabilitation

Varinia Montero-Vega, Rolando Carbonell-Riera

Article ID: 2115
Vol 3, Issue 2, 2022

VIEWS - 81 (Abstract)

Abstract

Introduction: cardiovascular disease in women is underestimated as a health problem. Among the therapeutic options is cardiac rehabilitation, which contributes to the reduction of morbimortality and hospitalization in both genders. Objective: to evaluate the initial behavior and results of a cardiac rehabilitation program in patients attended in the Cardiac Rehabilitation department of the Cardiology service of the General Teaching Hospital "Dr. Agostinho Neto", Guantánamo, during the period 2015–2019. Method: a descriptive, prospective and longitudinal study was carried out. The universe was constituted by 667 patients incorporated to the Cardiac Rehabilitation Program. Risk factors, ergometric parameters given by exercise time, heart rate, blood pressure and functional class were studied. A rehabilitation program was applied that included physical-aerobic and resistance exercises, ergometric tests and serum lipids at the beginning and at 6 months. Results: there is a different risk profile between both genders, obesity is the most prevalent risk factor in the female gender (62.9%) and active smoking in the male gender (78.0%). The improvement of physical capacity was greater in men than in women. The parameters used to improve women's participation and adherence to the program are presented. Conclusions: women have great barriers for incorporation to cardiac rehabilitation programs. It is necessary to provide them with information on the benefits to improve access and permanence in the program.

Keywords

cardiac rehabilitation; cardiovascular disease; gender

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References

1. Townsend N, Wilson L, Bhatnagar P, Wick-ramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe 2016: an epidemiological update. Eur Heart J 2016; 37(42):3232–45.

2. Directorate of Medical Records and Health Statistics. Anuario Estadístico de Salud 2018. Havana: Min-istry of Public Health; 2019. [cit-ed5Jan2021].Availablefrom: https://files.sld.cu/bvscuba/files/2019/04/A nuario-Electr%C3%B3nico-Espa%C3%B1ol- 2018-ed–2019-compressed.pdf.

3. Martinez CM. Differences between men and women in the incidence of heart dis-ease[Internet].Madrid:2017. Chap-ter 73.Cardiovascular health [cited 5 Jan2021].p:637–642.Available from: https://www.fbbva.es/microsites/salud_car dio/mult/fbbva_libroCorazon_cap73.pdf.

4. United Nations Children's Fund. Communication, childhood and adolescence: Guidelines for jour-nalists. 1ed. CODAJIC; 2017 May [cited 5 Jan 2021]. Available from: http://www.codajic.org/node/2612

5. Esquenazi Borrego A. Rosales Vázquez S, Velarde Hernández Y. Gender Inequality Index in Cuba: a territorial approach. Rev Est Desar Soc: Cuba and Latin America [Internet]. 2017 May-Aug [cited 5 Jan 2021]; 5(2):108–129. Available from: http://scielo.sld.cu/pdf/reds/v5n2/reds1121 7.pdf.

6. Perelman J, Fernandes A, Mateus C. Gender Dispar-ities in Health and Healthcare: Results from the Portuguese National Health Interview Survey. Cuad Saúde Púb [Internet]. 2017 [cited 10 Jan 2021]; 28(12). Available from: http://www.scielosp.org/scielo.php?script=s ci_arttext&pid=S0102–311X2012002001400012.

7. Campos-Serna J, Ronda-Pérez E, Lucía Artazcoz L, Benavides FG. Gender inequalities in occupational health in Spain. Gac Sanit [Internet]. 2017 [cited 10 Jan 2021]; 26(4). Availablefrom: http://scielo.isciii.es/scielo.php?script=sci_ar ttext&pid=S0213- 91112012000400009〈=pt

8. Maffei S, Guiducci L, Cugusi L, Cadeddu C, Deidda M, Gallina S, et al. Women-specific predictors of cardiovascular disease risk new paradigms. Int J Cardiol. 2019; 286:1907.

9. Lee JJ, Cook-Wiens G, Johnson BD, Braunstein GD, Berga SL, Stanczyk FZ, et al. Age at menarche and risk of cardiovascular disease outcomes: findings from the National Heart LungandBloodInsti-tute-sponsored Women's Ischemia Syndrome Eval-uation. J Am Heart Assoc [Internet]. 2019 [cited 10 Jan 2021]; 8(12):e012406. Available from: https://www.ahajournals.org/doi/10.1161/J AHA.119.012406.

10. Aggarwal NR, Patel HN, Mehta LS, Sanghani RM, Lundberg GP, Lewis SP, et al. Sex differences in is-chemic heart disease: Advances, obstacles, and next steps. Circ Cardiovasc [Internet]. 2018 [cited 10 Jan 2021]; 11(2):e004437. Available from:https://www.ahajournals.org/doi/10.1161/C IRCOUTCOMES.117.004437.

11. Supervía M, Medina-Inijosa JR, Yeung C, López Jimenez F, Squires R W, Pérez Terzic C, et al. Cardiac rehabilitation for women: A systematic review of barriers and solutions. Mayo Clin Proc [Internet]. 2017 Apr [cited 10 Jan 2021]; 92(4):565–577. DOI:https://doi.org/10.1016/j.mayocp.2017.01.0 02

12. Argentine Society of Cardiology. Argentine Con-sensus on Cardiovascular Rehabilitation. Rev Arg Cardiol [Internet]. 2019 [cited 10 Jan2021]; 87(3):58.Availablefrom: https://www.sac.org.ar/wp- content/uploads/2019/08/consenso–87- 3.pdf.

13. Sabo D. Understanding men's health. A relational and gender-sensitive approach. Harvard: PAHO; 2000 [cited 19 Jan 2021]. Available from:https://iris.paho.org/handle/10665.2/804

14. Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, et al. Acute Myocardial Infarction in Women: a scientific statement from the american heart association. Circulation [Internet]. 2016 [cited 19 Jan 2021]; 133(9):916–47.Availablefrom:https://www.ahajournals.org/doi/10.1161/C IR.00000000000000000351

15. Anderson L, Thompson DR, Oldridge N, Zwisler AD, Rees K, Martin N, et al. Exercise-based cardiac re-habilitation for coronary heart disease. Cochrane Database Syst Rev [Internet]. 2016 Jan [cited 11 Jan 2022]; 2016(1):CD001800.DOI:https://doi.org/10.1002/14651858.CD00180 0.pub3

16. Garcia M, Mulvagh SL, Bairey Merz CN, Buring JE, Manson JE. Cardiovascular Disease in Women Clinical Perspectives. Review. Circ Res [Internet]. 2016 [cited 11 Jan 2022]; 118:1273–93.DOI: http://dx.doi.org/10.1161/CIRCRESAHA.116. 307547

17. Yancy CW, Jessup M, Bozkurt B, Butler J, Donald E, et al. "2013 ACCF/AHA Guideline for the Man-agement of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines" Circulation [Internet]. 2013 Oct 15 [cited 11 Jan 2022]; 62(16):e147–239.DOI:https://doi.org/10.1016/j.jacc.2013.05.019

18. Molina DI, Chacón JA, Esparza AS, Botero SM. Depression and cardiovascular risk in women. Rev Colom Cardiol [Internet]. 2016 May-Jun [cited 11 Jan 2022]; 23(3):159–252.DOI: http://dx.doi.org/10.1016/j.rccar.2015.11.00 4

19. Gaalema DE, Savage PD, Jason R, Cutler AY, Elliott RJ, Priest JS, et al. Patient Characteristics predictive of Cardiac Rehabilitation Adherence. J Cardiopulm Reh Prev [Internet]. 2017 Mar [cited 11 Jan 2022]; 37(2):103–10. Available from: https://pubmed.ncbi.nlm.nih.gov/28033166/

20. Warburton DE, Bredin SS. Reflections on physical activity and health: what should we recommend? Can J Cardiol. 2016; 32:495–504.

21. Cuellar Gallardo A, Gómez García Y, CastroTorres Y, Triana Díaz A, et al. Cardiovascular rehabilitation in patients with ST-segment elevation acute myocar-dial infarction and percutaneous coronary inter-vention. CorSalud [Internet]. 2019 [cited 11 Jan 2022]; 11(4):278–286. Available from: http://www.revcorsalud.sld.cu/index.php/co rs/article/view/387/1057.

22. Rivas Pérez, A, Vélez Salas, A, Dalmau Gonzá-lez-Gallarza R, Castro Conde, A and López Sendón JL. Cardiac rehabilitation in young women: Does it adapt to their needs? Rev Esp Cardiol. 2017; 70(Suppl 1):271.

23. Prado Díaz S del, Montoro López M, Dalmau González-Gallarza R, Castro Conde A, et al. Benefits of cardiac rehabilitation in women after acute cor-onary syndrome. Rev Esp Cardiol [Internet]. 2015 [cited 11 Jan 2022]; 68 (Suppl 1):1119. Available from:https://www.revespcardiol.org/es- congresos-sec–2015-el-congreso–19-sesion- rehabilitacion–1652-beneficios- rehabilitacion-cardiaca-mujeres-despues- 18935-pdf.

24. Piché ME, Poirier P, Lemieux I, Deprés JP. Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update. Prog Cardiovasc Dis. 3018; 61:103–113. 2017.

25. Lee JJ, Pedley A, Hoffman U, Massaro JM, Levy D, Long MT. Visceral and intrahepatic fat are associ-ated with cardiometabolic risk factors above other ectopic fat depots: the Framingham Heart Study. Am J Med [Internet]. 2018 [cited 11 Jan 2022]; 131:684–692.e12.DOI:https://doi.org/10.1016/j.amjmed.2018.02.0 02

26. Quiros Fallas R. Update on cardiovascular risk fac-tors. Rev Méd Sinergia [Internet]. 2017 Jan [cited 11 Jan 2022]; 2(1):3–7.Availablefrom: https://revistamedicasinergia.com/index.ph p/rms/article/view/57

27. Puentes Valle D, Rodríguez Pérez LA, Pupo Ávila NL, Sit Pacheco R. The munticomponent group treat-ment: an effective method against smoking. Rev Cubana Salud Púb [Internet]. 2019[cited 11Jan 2022]; 42(2):e1288.Available from: http://scielo.sld.cu/pdf/rcsp/v45n2/1561- 3127-rcsp–45–02-e1288.pdf.

28. Smith PH, Kasza KA, Hyland A, et al. Gender dif-ferences in medication use and cigarette smoking cessation: results from the international Tobacco control four country. Nicotine ton res Off. J Soc Res Nicotine Tob. 2015; 17(4):463–472.

29. Moreno Hernández M, Gonzalvo Ortega M, Olague Baño C, de la Cierva Delicado A, López Cubero T, et al. Effect of cardiac rehabilitation on improving exercise capacity. Rev Clin Esp. 2018; 218: 905.

30. Santiago de Araújo Pio C, Marzolini S, Pakosh M, Grace SL. Effect of Cardiac Rehabilitation Dose on Mortality and Morbidity: A Systematic Review and Meta-regression Analysis. Mayo Clin Proc. 2017; 92(11):1644–1659.

31. Asbury EA, Slattery C, Grant A, Evans L, Barbir M, and Collins P. Cardiac rehabilitation for the treat-ment of women with chest pain and normal coronary arteries. Menopause. 2008; 15(3):454–460.

32. Darren ER, Warburton DE, Bredin SS. Reflections on physical activity and health: what should we rec-ommend? Can J Cardiol [Internet]. 2016 [cited 11 Jan 2022]; 32(4):495–504.DOI:https://doi.org/10.1016/j.cjca.2016.01.024

33. Sanchez-Delgado JC, Betty LM, Angarita Fonseca A, et al. Reliability of the barriers scale for cardiac re-habilitation. Rev Colom Cardiol. 2018; 25(1):84–91.

34. Ros Sanchez T, Lindon Cerezuela B. The experience of empowerment in women over 65 years old. A qualitative study. Gerokomos. 2018; 29(1):3–8.

35. National Ministry of Health. Manual for the care of people with chronic noncommunicable diseases: comprehensive management at the first level of care. Geneva: WHO; 2017.

36. Anchique CV, Fernández RO, Zeballos C. Cardio-vascular rehabilitation in women. Rev Colom Car-diol. 2018; 25(S1):99–105.

DOI: https://doi.org/10.54517/ccr.v3i2.2115
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