Cardiac Rehabilitation Offers Unique Benefits to Women

Cardiac rehabilitation, a program with demonstrated success, offers unique benefits to women who participate. Despite these benefits, women tend to take advantage of this program less than men.

Cardiac rehabilitation (rehab) is a multi-session program for patients who have had a cardiac-related event or procedure, such as having undergone bypass or stable angina. The program helps patients recover quicker and prevent future heart attacks or stroke. Learn more: Cardiac Rehabilitation

In 2022, 29.3% of women in Minnesota who experienced a cardiac rehab qualifying event-initiated CR compared to 40.9% of men, according to MDH data. This disparity is concerning.

Susan Magdziak, a physical therapist and senior director of rehabilitation for acute care teams at M Health Fairview, found herself needing cardiac rehab after an unexpected medical event in May of 2024. After suffering from several days of what she thought was reflux, Susan sought care in the Emergency Department. She then learned the reflux symptoms she was experiencing were actually a spontaneous coronary artery dissection (SCAD), a sudden tear or separation in the arteries that supply blood to the heart. While in the hospital Susan went into cardiac arrest. See below for more information on SCAD.

After her experience, Susan was afraid to get back to some of her normal activities like exercise. She worried about the rhythm of her heart and wanted the reassurance and support of monitored exercise. So, she took advantage of the outpatient cardiac rehabilitation program at M Health Fairview Ridges.

Dedicated time for healing and recovery

Women may face many barriers to cardiac rehab for a variety of reasons that include:

• Lower referral rates due in part to clinician bias because women with a cardiac qualifying diagnosis or event tend to be older and have more comorbidities (Khadanga, 2021)
• Social drivers of health that include lack of or inadequate insurance, transportation challenges, social isolation (Supervia, 2017)
• Family and caregiving responsibilities (Grace, 2009)

For three sessions a week, over the course of several months, Susan participated in monitored, progressive exercise under the supervision of a cardiac rehab specialist. Her goals were to improve her cardiovascular efficiency, endurance. and strength. The sessions helped Susan rebuild confidence in her capacity to exercise on her own and trust that her heart would respond appropriately.

While Susan reaped positive benefits from the supervised exercise, she also described some unexpected benefits: a sense of belonging and support from being in a group setting, increased knowledge about nutrition and heart healthy eating strategies, and stress management techniques.

Another important aspect of participating in cardiac rehab were the benefits of carving out dedicated time for herself and her recovery. As a busy mom of two, balancing work and family responsibilities, Susan tended to prioritize the needs of others over her own health. However, when it came to cardiac rehab, she stated that “making it a priority was important for my recovery.”

Programs can be tailored to fit patient needs

Susan was fortunate in her ability to take time off work and engage her supportive spouse in taking on some of her family responsibilities. This allowed her to attend 36 sessions, the full recommendations. That may not be possible for everyone. Each individual's cardiac rehab journey can be tailored to meet them where they’re at. For example, patients can elect to attend fewer total sessions or attend at a lower frequency and still receive some benefit. Cardiac rehab professionals are skilled at working with individuals to develop a plan that works for them. Susan encourages anyone who is eligible for cardiac rehab to attend an initial evaluation and determine the appropriate dose, length, and frequency of sessions.

Referring and enrolling more women in cardiac rehab is important. Research shows that women engaged in cardiac rehab reduce their risk of dying significantly, even more than men (Ekblom, 2020). Women with SCAD, like Susan, who participate in cardiac gain improvements in exercise capacity and modest mental health scores (Silber, 2015).

Additional resources

• MDH: About High Blood Pressure
• American Heart Association: What is Cholesterol
• Tobacco Cessation – Quit Partner MN

References

Grace, S. L., Gravely-Witte, S., Kayaniyil, S., Brual, J., Suskin, N., & Stewart, D. E. (2009). A multisite examination of sex differences in cardiac rehabilitation barriers by participation status. Journal of women's health (2002), 18(2), 209–216. https://doi.org/10.1089/jwh.2007.0753

Khadanga, S., Gaalema, D. E., Savage, P., & Ades, P. A. (2021). Underutilization of Cardiac Rehabilitation in Women: BARRIERS AND SOLUTIONS. Journal of cardiopulmonary rehabilitation and prevention, 41(4), 207–213. https://doi.org/10.1097/HCR.0000000000000629

Supervía, M., Medina-Inojosa, J. R., Yeung, C., Lopez-Jimenez, F., Squires, R. W., Pérez-Terzic, C. M., ... & Thomas, R. J. (2017, April). Cardiac rehabilitation for women: a systematic review of barriers and solutions. In Mayo Clinic Proceedings (Vol. 92, No. 4, pp. 565-577). Elsevier.