Cardiac Rehabilitation in Women

Cardiac rehabilitation (CR) programmes include a range of medical and lifestyle interventions, such as exercise training, dietary advice, stress management, medication adherence, and education on heart-healthy living. The programmes are typically supervised by a multidisciplinary team of healthcare professionals and are designed to address risk factors such as high blood pressure, high cholesterol, diabetes, smoking and depression. Participation in CR decreases morbidity and mortality and has therefore a class 1A recommendation in international guidelines. Despite this strong recommendation, participation in CR is low and women are poorly represented. There are barriers at an individual level (co-morbidities, pelvic floor changes following pregnancy and menopause, depression, family responsibilities) and at a system level (distance to CR centres, educational attainment, belonging to an ethnic minority group, and lack of physician referral). Increasing referral, enrolment and participation should be a high priority. Automatic or systematic referral has been shown to increase the number of participants in CR, and adherence to CR may be higher if remote or home-based interventions are included. Carer involvement can play a crucial role in the success of CR.