New guidelines produced to improve cardiovascular disease outcomes in women


“Female-focused” rehab counseling has been designed to try to engage more women with cardiovascular disease and improve their outcomes.

It is well known that, overall, women suffer from more serious cardiovascular disease and are less likely to engage in prevention and rehabilitation programs.

In response, experts have now developed clinical practice guidelines to help those working in cardiac rehabilitation deliver more women-centered and effective programs.

The team was assembled by the International Council for Cardiovascular Prevention and Rehabilitation, and the guidelines have been endorsed by 24 clinical societies around the world.

Lead author Professor Sherry L. Grace, York University School of Health and KITE-Toronto Rehabilitation Institute and Peter Munk Cardiac Centre, University of Toronto, said: “There is women have long been much less likely to have access to comprehensive cardiac rehabilitation, and often have poorer outcomes, despite having greater needs than men.

“As a result, ‘women-centric’ models of cardiac rehabilitation have been developed to better engage women and optimize their outcomes. There is now enough evidence on female-focused cardiac rehabilitation to make recommendations to the cardiac rehabilitation community.

Globally, cardiovascular disease is the leading cause of death among women, with rising mortality rates in a number of countries in Africa, Asia and the Western Pacific.

The new guidelines aim to reduce deaths and hospitalizations and improve function, psychosocial well-being and quality of life.

Key recommendations include:

  • A systematic referral process, with women encouraged to undergo drug treatment before discharge from hospital
  • When developing bespoke rehabilitation plans, considerations should include mental and psychosocial health issues, menopausal status, frailty, history of cancer, concerns about urinary incontinence, and risk of falls/osteoporosis
  • If resources are limited, programs could include women-only virtual education or exercise sessions or peer support
  • Choice offered in terms of centre-based or home-based facilities, delivered in a women-friendly environment
  • Programs should include a strong psychosocial component, choice of exercise, and specific education on women and cardiovascular disease.

Professor Grace said: “For the first time there is a consensus definition and recommendations for female-focused cardiac rehabilitation, so we now hope that many programs will incorporate these elements into their programmes.

“If implemented, more women can engage in cardiac rehabilitation and, as a result, have a significantly higher quality and longer life.”

The guidelines were developed based on feedback from women-focused cardiac rehabilitation researchers around the world. Many came from Canada, considered a leader in this field.

The study was published in the Canadian Journal of Cardiology.

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