Optimal gender-specific strategies for the secondary prevention of heart disease in women : a systematic review

Background: There is a paucity of evidence on gender-specifi c, individually tailored secondary prevention (cardiac rehabilitation [CR]) services for women with heart disease. Women participate less in CR programs, thus increasing their risk of further cardiac events. This review aims to (1) determine the effectiveness of gender-specifi c interventions specifi cally designed for women with heart disease, delivered in outpatient CR settings; and (2) classify key elements of effective CR strategies/models for women with heart disease. Methods: Using the PRISMA guidelines, this is a systematic review of CR models tailored to women to improve cardiovascular risk. Four databases were searched for randomized controlled trials (RCTs) between January 1974 and July 2017 published in peer-reviewed English language journals. Results: Three RCTs comprising 725 women of gender-specific CR strategies were identifi ed. Signifi cant improvements were found in one-third (1 study) of the included multicomponent CR strategies for outcomes including general health, social functioning, vitality, mental health, depression, and quality of life. Conclusion: Further large-scale RCTs are required to replicate positive fi ndings and accurately assess the capacity for gender-specifi c multicomponent CR programs that incorporate participant-driven collaborative models to moderate psychological risk and improve functional capacity and quality of life for women with heart disease.