There’s a proven way for men and women to slash their risk of dying from heart disease, yet few women take advantage of the opportunity—often because their doctors don’t tell them about it. Called cardiac rehabilitation, it’s a simple program that’s widely available and hugely helpful, yet vastly underused. A new study shines a spotlight on the dark facts.
Study participants included nearly 26,000 patients with coronary artery disease (CAD), a buildup of waxy plaque in the arteries that deliver blood and oxygen to the heart. CAD affects about 20% of people age 65 and older and is the leading cause of death for both women and men. Cardiac rehab typically is a 12-week outpatient program appropriate for people who have been diagnosed with CAD, have suffered a heart attack or have some other heart problem. It is an individualized program that includes supervised exercise sessions, nutrition counseling, stress-management training, smoking-cessation assistance and encouragement to make permanent lifestyle changes. For the study, researchers reviewed medical records spanning up to 15 years to see who attended cardiac rehab and how much it helped boost patients’ survival.
Findings: The good news was that women with CAD who attended rehab were 66% less likely to die than women who did not attend. Rehab also benefited men with CAD, but not to as great a degree. However, only 31% of the women in the study were ever even referred to a cardiac rehab program by their doctors, compared with 42% of men. Physicians don’t deserve all the blame, though—because among the patients who did get a rehab referral, only 50% of women (versus 60% of men) bothered to go.
Though the study didn’t look at why so few women were referred to cardiac rehab, it could be that many doctors as well as patients still mistakenly think of heart disease as “mostly a man’s problem”…or that some doctors refer only their healthier female heart patients to rehab, assuming that sicker ones are too ill to be helped.
As for why women who were referred declined to go? Researchers speculate that women may feel that they have too many family obligations and other responsibilities to make time for rehab…and that women tend to put their own health needs on the back burner. That’s ironic, though—because if women with CAD don’t take care of themselves, they won’t be around to take care of their families.
Though this new research was conducted in Canada, smaller studies have shown that the same problem occurs in the US. Self-defense: Male or female, if you have CAD or some other cardiovascular problem (for instance, a history of heart attack, bypass, angioplasty, stenting, angina, valve surgery or heart transplant), don’t wait for your doctor to bring up the subject of cardiac rehab—come right out and ask whether it’s appropriate for you. If the doctor says you don’t need it, request a detailed explanation…and consider getting a second opinion, too. And if you are referred for cardiac rehab, go! Programs are offered at many hospitals and medical centers and typically are covered by Medicare and other health insurance.
