Women's College Research Institute

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Breaking down barriers between women and cardiac rehab

July 2012

Dr. Paula HarveyWomen with heart problems rarely follow-up when they’re referred for cardiac rehabilitation, but their participation can be boosted when doctors consider factors that can influence their access to care, according to Dr. Paula Harvey, a scientist at Women’s College Research Institute.

“Cardiac rehabilitation has proven very effective for reducing the risk of future heart problems, and we know that women are at equal if not higher risk for heart disease compared to men,” says Harvey, who co-led the study with Mireille Landry, a physiotherapist and Jennifer Price, a nurse practitioner, in Women’s College Hospital’s cardiac rehabilitation program.

“There are many barriers that dissuade women from completing their intake assessments and that also discourage them from continuing in cardiac rehab,” says Harvey. “Through our research, we’re working to identify why women are less likely than men to participate.”

The team recently presented their findings at the American College of Sports Medicine’s 59th Annual Meeting in San Francisco.

Heart disease is the leading cause of death in both men and women. Exercise-based cardiac rehabilitation – which helps patients implement exercise and nutrition-based lifestyle changes to reduce their risk of future heart problems – is proven to be effective.

Yet when a woman who has had a heart attack is referred to a cardiac rehabilitation, she is far less likely to attend her intake assessment than a man.

Harvey’s team found that depression and arthritis were the most frequently cited reasons for not partaking.

“There is a perception that arthritis pain may be a barrier to cardiac rehab,” says Harvey. “This perception may be physician-based, patient-based or both. Yet we know that appropriate exercise can actually relieve symptoms of osteoarthritis.”

The researchers also found that distance and transportation issues are a significant barrier to participation. Of the respondents, 26 per cent listed these barriers as a specific challenge for beginning cardiac rehabilitation.

“The take-home message here is that when referring a patient to cardiac rehab, physicians really need to ensure they’re matching patients with programs that are as local to them as possible, and assure patients that their regimen will be tailored to their physical needs and limitations,” says Harvey.

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