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Secondary Prevention Recommendation Attainment with Cardiac Rehabilitation: Is There a Gender Disparity? Womens Health Issues 2016 May-Jun;26(3):278-87

Date

04/04/2016

Pubmed ID

27039277

DOI

10.1016/j.whi.2016.03.004

Scopus ID

2-s2.0-84962109433   4 Citations

Abstract

BACKGROUND: Achievement of secondary prevention guideline recommendations (i.e., goals) with cardiac rehabilitation (CR) is not well-documented, especially for women. This study examined achievement of the American Heart Association/American College of Cardiology (AHA/ACC) goals before and after CR by gender.

METHODS: Of 12,976 patients enrolled in the Wisconsin CR Outcomes Registry, 8,929 (68.8%) completed CR and were included in the sample. Attainment of 15 AHA/ACC goals before and after CR was examined by extracting corresponding data points in the registry as entered by CR program staff. Gender differences in achievement of these goals after CR were examined via generalized estimating equations technique.

RESULTS: Attainment of AHA/ACC goals before CR ranged from 15.3% of patients (physical activity) to 98.1% (aspirin), and by 17.6% (physical activity) to 98.4% (diastolic blood pressure) by CR completion. Significant improvements were achieved for 8 goals (53.3%), ranging from 0.7% for body mass index (BMI) to 50.8% for physical activity. Women were significantly less likely than men to achieve the following goals by CR completion: triglycerides (adjusted odds ratio [AOR], 0.54; 95% confidence interval [CI], 0.45-0.66), physical activity (AOR, 0.66; 95% CI, 0.59-0.74), and hemoglobin A1C (AOR, 0.50; 95% CI, 0.32-0.78). Women were significantly more likely than men to achieve the high-density lipoprotein goal (AOR, 1.39; 95% CI, 1.05-1.86). There were no gender differences in goal achievement for blood pressure, total cholesterol, low-density lipoprotein, BMI, smoking cessation, or medication use. More than 94% of patients were taking three of four recommended secondary prevention medications both before and after the program.

CONCLUSIONS: Men and women generally improved similarly in terms of AHA/ACC goal achievement. Quality improvement strategies need to focus on physical activity and blood glucose control in women.

Author List

Turk-Adawi KI, Oldridge NB, Vitcenda MJ, Tarima SS, Grace SL

Author

Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Cardiac Rehabilitation
Cardiovascular Diseases
Female
Gender Identity
Humans
Middle Aged
Patient Compliance
Registries
Retrospective Studies
Risk Factors
Secondary Prevention
Wisconsin
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0