Low referral rates, low income keep women out of cardiac rehab programs

New research may help explain why women who suffer from heart disease are less likely than men to participate in potentially lifesaving cardiac rehabilitation programs.

Women hospitalized for a heart attack or unstable angina are far less likely than men to be referred to cardiac rehabilitation programs, even if they are good candidates, a new study in the April issue of General Hospital Psychiatry reveals.

The same study documents that even when women are referred, they complete the programs less frequently than men do. Lead investigator Sherry L. Grace, Ph.D., of the University Health Network Womens Health Program in Toronto, cites evidence that this difference could stem from characteristics that are more common among the women: lower family income and less confidence that they can take action to improve their heart health.

Although cardiovascular disease is the leading cause of death and disability among both men and women, Grace notes, women have repeatedly been shown to be less likely to recover well. A woman who has a heart attack is more likely than a man to have a second attack or die within the first year.

At the same time, many studies document that women with heart disease are less likely than their male counterparts to participate in cardiac rehabilitation programs, which can decrease the risk of death by 25 percent.

Graces team followed 906 men and women from 12 coronary intensive care units in South-central Ontario. Each subject was observed during six months of normal care after admission for either a heart attack or unstable angina.

Each participant supplied basic demographic information, such as family income and age, and completed tests designed to measure such traits as anxiety levels and strength of social supports.

The results, Grace reports, duplicate previous observations of lower referral rates for women. Among eligible patients, 32 percent of men -- but only 21 percent of women --

Contact: Sherry Grace
Center for the Advancement of Health

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