It's a harsh reality: Fewer women are participating in cardiac rehabilitation, even though it could dramatically improve their lives after a heart event. This is a critical issue, and understanding why is key to saving lives. Let's dive in.
For anyone who's undergone heart surgery or experienced a major cardiovascular event, cardiac rehabilitation is a game-changer. This comprehensive program combines exercise, lifestyle adjustments, and education to aid recovery, both in the short and long term. Patients who engage in cardiac rehab see a significant reduction in hospital readmissions and a lower risk of future heart attacks.
But here's where it gets controversial: despite these undeniable benefits, the participation rates are disappointingly low, especially among women. Research reveals that even when women do participate, they're less likely to complete the program compared to men. This disparity is a serious concern, and we need to understand the underlying causes.
Dr. Jessica Golbus, a cardiologist at the University of Michigan Health Frankel Cardiovascular Center, has dedicated her work to this issue. In October 2025, Dr. Golbus co-authored an American Heart Association scientific statement on cardiac rehabilitation in women, published in Circulation. The statement meticulously examines the advantages, barriers, and potential solutions to boost women's participation.
So, how exactly does cardiac rehab benefit women? According to Dr. Golbus, it offers universal advantages by reducing risk factors for future cardiovascular events. This includes lowering blood pressure and cholesterol levels, ultimately enhancing the overall quality of life. Even though women participate less frequently, studies show that those who do experience benefits at least equal to those seen in men. The evidence overwhelmingly supports cardiac rehabilitation as an essential tool for patients to optimize their recovery. Dr. Golbus encourages anyone who might be eligible to discuss it with their clinical team and consider joining the program.
But why is participation so low among women? Dr. Golbus points to a variety of barriers.
First, women often face lower referral rates for cardiac rehabilitation compared to men. This could be due to differences in diagnoses or, in some cases, clinician bias. It's a fact that patients are far more likely to enroll in cardiac rehabilitation when their clinician recommends it. Unfortunately, clinicians are sometimes less likely to have that crucial conversation with women, which is even more pronounced among women from underrepresented racial groups. Other factors, like insurance coverage issues, transportation challenges, and social isolation, can also limit participation. Women are also more likely to be caregivers, and those responsibilities can make it difficult to enroll.
And this is the part most people miss: cardiac rehab programs sometimes struggle to fully meet women's unique needs. Women who have experienced major cardiovascular events may have specific requirements. For instance, both men and women are likely to experience depression and psychosocial distress after a cardiovascular event, but this is often more pronounced in women. Women tend to be older at the time of their heart event and may have other health conditions that limit their ability to exercise. Furthermore, women are more likely to be referred to cardiac rehabilitation after less common cardiovascular diagnoses, such as a coronary artery dissection. Despite these unique needs, the research shows that all patients who qualify for cardiac rehabilitation have the potential to benefit.
So, what can be done to reduce this disparity? Dr. Golbus emphasizes the need for targeted interventions. A multi-faceted approach is essential.
One of the easiest ways to improve the situation is to increase referrals for women. Studies have shown that implementing an automatic referral process can significantly boost the numbers. Other strategies, such as a physician's recommendation or facilitated enrollment through a case manager, have also proven effective in raising awareness and improving enrollment. Cardiac rehabilitation teams could also consider tailoring programs to women's specific needs. This might involve a broader range of exercise options, focused education, or more extensive psychosocial support. Peer support groups can also be beneficial, as they're linked to increased quality of life and lower depression and anxiety scores, all of which affect attendance. Finally, exploring virtual cardiac rehab, which incorporates digital health technologies, could eliminate transportation barriers and improve access for those unable to attend center-based programs.
What do you think? Are you surprised by these findings? Do you have any personal experiences or insights to share about cardiac rehabilitation? Let's discuss in the comments below!
Source: Coutinho, T., et al. (2025). Cardiac Rehabilitation in Women: A Scientific Statement From the American Heart Association. *Circulation. doi.org/10.1161/cir.0000000000001379*
