Women-Only Cardiac Rehab May Alleviate Anxiety, Depression, Hints Study

Deborah Brauser

February 05, 2016

TORONTO, ON — Participating in women-only cardiac rehabilitation (CR) programs after experiencing an acute coronary event may help alleviate both anxiety and depression in female patients, new research suggests[1].

Results from the Cardiac Rehabilitation for Heart Event Recovery (CR4HER) study showed that the participants randomized to women-only rehab had significantly lower anxiety and depressive symptoms vs the women randomized to undergo mixed-sex cardiac rehab. Although both groups had increased quality-of-life scores from before to after the intervention, only those in the women-only program had significantly improved diet scores.

However, the associations did not hold after full adjustments.

Still, "given the high degree of anxiety observed" in the study population, the findings deserve more research," write the investigators, led by Liz Midence (York University, Toronto, ON).

"Overall, strategies to ensure more women use CR, regardless of model, should be implemented," they add.

The results were published online February 3, 2015 in the Canadian Journal of Cardiology.

Program Advantages?

As reported by heartwire from Medscape, primary results released earlier from the CR4HER study showed that cardiac-rehab adherence was very low among the women, with only 55% of the 169 participants completing all 24 prescribed rehab sessions.

For prespecified secondary outcome analysis, the investigators examined 144 of the participants who enrolled in cardiac rehab and took part in the intervention intake assessment. All were assigned to attend either supervised women-only or coed on-site programs or to participate in home-based rehab for 4 to 6 months. Follow-up assessments were conducted at the 6-month point.

Baseline measures included the Patient Health Questionnaire-2, several self-report surveys, and graded exercise stress tests.

From baseline to follow-up, quality-of-life scores increased significantly for the women-only group (per protocol, P=0.02; as treated, P=0.007) and the mixed-sex group (both P<0.05).

Both supervised groups also had significant increases in self-reported physical activity (per protocol, P=0.002 and 0.001, respectively; as treated, P=0.01 and 0.001). However, only the women-only group had significant increases in their total Diet Habit Survey scores (as treated, P=0.04).

In addition, anxiety symptoms were significantly higher in the mixed-sex than in the women-only groups (per protocol, P=0.048; post hoc least significant difference [LSD], P=0.02), as were depressive symptoms (overall, P=0.005; post hoc LSD, P=0.001).

However, there were no significant differences by model after adjustment for confounding variables such as age and program adherence.

"Taken as a whole, these findings suggest that behavioral and psychosocial outcomes were largely equivalent regardless of program model; however, women-only programs may confer an advantage for anxiety and depressive symptoms," write the investigators.

In addition, "promoting greater use of CR among women and wider availability of motivationally focused CR programs . . . may represent important means to improve women's cardiac outcomes," they conclude.

The study was funded by a grant from the Heart and Stroke Foundation of Ontario. The study authors report no relevant financial relationships.

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