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Cardiac Rehabilitation Aids Women Most

Women who try to enhance their cardiovascular diet, exercise and other habits improve their cholesterol levels more over time than men do, according to a study released on Monday. The results showed that men and women with heart disease had similar higher levels of “good” cholesterol and lower levels of “bad” cholesterol after the first year of the therapeutic regimen. However, only the women continued to show improvement in cholesterol levels throughout the five-year program, while men seemed to level off after the first year. The study was conducted by a research team at Wake Forest University in Winston-Salem, N.C., and its Bowman Gray School of Medicine.

Dr. James G. Warner Jr., the lead author of the study, said the team could establish no reason for the disparity. But he had an idea: “Women often have more room for improvement at the beginning than men.” Generally, he said, the women began the program with more body fat and higher blood cholesterol levels than men, as well as slower metabolisms.

The therapy regimen consisted of several elements:

The study included all 719 heart patients who participated in the Wake Forest Cardiac Rehabilitation Program from 1988 to 1993. Most of the patients were referred to program after a heart attack, coronary bypass surgery or balloon angioplasty to open up clogged coronary arteries. Of the group, 553 were men, with the average age being 60, and 166 were women, with the average age being 57.

The lopsided ratio of men to women is not unusual in the nation's cardiac rehabilitation programs, Dr. Warner said. “I think that there's a referral problem,” he said. “There are significantly fewer women who are referred to cardiac rehabilitation programs than men.” Dr. Warner and other experts also noted the mistaken assumption, especially among older generations, that heart disease is not as big a threat to women as it is to men.

Dr. Warner urged women to consult their doctors about whether behavioral changes would improve their cardiac health. Dr. Gordon Blackburn, director of the cardiac rehabilitation program at the Cleveland Clinic in Ohio, said the report “raises some interesting questions.”

“The one thing I find most overwhelming is that it's a five-year study,” he said. “It suggests that we need to have longer involvement with cardiac patients, especially women. The problem is that Medicare currently pays for only 12 weeks or 36 sessions, whichever ends soonest.”

Source: NY Times, 8/16/95. Report from Dallas, Aug.15 (AP)


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