Individually tailored cardiac rehabilitation: will the dream come true by identifying sex- and age-related differences by assessing health-related quality of life at entry? (original) (raw)

European Journal of Preventive Cardiology

Awareness of sex differences in medical diagnosis, treatment, secondary prevention of cardiovascular disease (CVD), and cardiac rehabilitation (CR) has been in focus of the scientific community for more than two decades, 1-4 resulting in a significant improvement in knowledge and therapeutic treatment of CVD in women. 1-4 Nevertheless, a recently published comprehensive review of sex differences in CR 5 still reveals numerous gaps regarding the optimal referral, enrolment, implementation, and effectiveness of CR in women. The authors identify numerous gender-specific differences in the administration of core components of CR, that must be taken into account in CR implementation to meet the particular preferences, expectations, and needs of female patients. 5 In this context, the authors highlight, among others, the higher prevalence of psychosocial burden in female patients at CR entry compared with men, which requires special attention and treatment strategy during CR. 5 The authors point out that gender differences in CR and their impact on CR outcomes are still insufficiently studied. 5 Interestingly, sex differences in health-related quality of life (HRQOL) were not included into the discussion in this review. 5 It remains unclear, why the authors did not address this issue in their review. Very recently, HRQOL outcomes during CR were analysed for the first time by meta-analysis specifically for women. 6 In this systematic review, 6 the authors found 11 studies (n = 1.237 women; mean age 61-70 years), eligible for inclusion. Only three of these studies were randomized controlled trials (RCTs), six prospective observational studies, and two quasi-experimental studies. In 6 out of these 11 studies, only women were included, and in five studies, the