The effectiveness of cardiac rehabilitation programs in females following an acute myocardial infarction
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The incidence of myocardial infarctions (MIs) is increasing yearly in the United States and with it the concurrent morbidity (ie., disability) and mortality resulting from these events. Although once considered a “male” disease, recent epidemiological studies have reported approximately 2.8 million females have a myocardial infarction (MI) each year. While cardiac rehabilitation programs (CRP) have shown success in reducing risk factors for secondary event, the majority of these successes have been reported for male patients. That is, whether or not the same outcomes have occurred for female MI patients as a result of CRP have not been adequately addressed. The purpose of this paper was to review the literature in an attempt to determine if current CRP are equally effective for both genders. Methodology: A systematic review of the literature was performed in order to evaluate the data on the outcome of CRP between genders during the time frame of 1986-2006. Articles evaluated included data on the outcome of CRP between males and females. The following MeSH search terms were used: cardiac rehabilitation, gender differences, females, compliance, effectiveness, myocardial infarction, and heart attack. Results: Twenty-one articles met the inclusion criteria. Nine of the articles directly addressed the outcome of females in CRP while six indirectly addressed outcome based on referral and utilization patterns. Five articles were background articles. Discussion: Based on the literature, CRP are not as effective for females since CRP were developed originally for males. Female clinical profiles vary from males, with females having more comorbidities at an older age, thus CRP fail to address the unique needs of females following a myocardial infarction. This discrepancy may lead to a lack of compliance and failure to adequately improve physically and emotionally following an MI. These findings are significant to determine the importance of developing more applicable and appropriate CRP that focus on the specific needs of females. This knowledge may enhance females’ CR experience, adherence, and outcomes. Limitations of this review include the inability to experience the results directly, the variable methodology of previous studies, and the lack of high quality studies addressing females in CRP specifically. Conclusion: While the incidence of myocardial infarctions is increasing dramatically in females, CRP still fail to understand and address the multidimensional differences between males and females in terms of responding to and adhering to CRP. As a result, this review hopes to shed more light onto the need for CRP more specifically designed to meet the needs of females.
A project presented to the Department of Physician Assistant of Wichita State University in partial fulfillment of the requirements for the degree of Master of Physician Assistant.
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