Greater Improvements in Health-Related Quality of Life Following Cardiac Rehabilitation Among Women and Ethnic-Minority Patients.

Background

Cardiac rehabilitation (CR) is a cornerstone of secondary prevention following cardiovascular events; however, variability in its benefits across sociodemographic groups remains incompletely understood.

Objective

To evaluate differences in changes in health-related quality of life (HRQoL) following CR across sociodemographic and clinical characteristics.

Methods

In this prospective study, 464 consecutive patients participating in a CR program were assessed. Using the Short-Form Survey-12 questionnaire, HRQoL was evaluated at baseline and upon program completion. Functional capacity (six-minute walk test and exercise cardiac stress test), clinical characteristics, and adherence rates were analyzed across subgroups defined by gender, ethnicity, and timing of CR initiation.

Results

Significant improvements in both physical and mental HRQoL outcomes were associated with participation in CR (P < .001). Women and ethnic-minority patients presented with lower baseline HRQoL; however, they demonstrated greater relative improvements in physical and mental domains, respectively (P < .05 and P < .001). Despite these benefits, ethnic-minority patients exhibited lower adherence rates (P < .01). Early initiation of CR (≤90 days) was associated with superior baseline functional capacity, as reflected by greater six-minute walk test distances and higher metabolic equivalents.

Conclusions

Women and ethnic-minority patients derive substantial HRQoL benefits from CR despite lower baseline status, yet remain less engaged in rehabilitation programs. These findings highlight a critical gap in secondary prevention and underscore the need for targeted, equity-oriented strategies to improve participation and maximize outcomes in high-benefit populations.