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Women and MEN profit equally from cardiac rehabilitation: a secondary analysis of the opticare RCT

N. ter Hoeve, M. de Bakker, M. Sunamura, Jeanine E. Roeters van Lennep, E. Boersma, R. V. D. van den Berg-Emons

Journal of Rehabilitation Medicine, 2026

642 participants · 1 citation

Abstract

Purpose To explore sex-specific differences in cardiac rehabilitation (CR) outcomes. Methods Aerobic capacity (6-Minute Walk Test), physical behaviour (accelerometer), cardiovascular risk profile (weight, blood pressure, cholesterol), and psychosocial well-being (questionnaires) were measured in patients after an acute coronary syndrome (147 women, 642 men) at CR start and completion, and 18 months’ follow-up. Sex differences were studied using GEE models adjusted for age and differences in baseline characteristics. Additionally, whether men and women met targets associated with health risk reductions was assessed. Results Both sexes experienced similar CR benefits. Only for depressive symptoms did women show larger improvements (HADS score; ♀: –2.7 vs ♂: –1.1; p = 0.017). Nevertheless, long-term follow-up revealed women still lagged in meeting targets for physical activity (♀: 76.5% vs ♂: 93.1%; p < 0.001) and anxiety symptoms (♀: 75.5% vs ♂: 86.8%; p < 0.001), while men lagged in meeting aerobic capacity targets (♀: 71.3% vs ♂: 58.8%; p < 0.001). Conclusion Women experience similar CR benefits to men in aerobic capacity, physical behaviour, cardiovascular risk profile, anxiety, and quality of life, with greater improvement in depressive symptoms. However, target values were less often met by women in physical behaviour and psychosocial well-being, and by men in aerobic capacity. Tailored CR programmes may be needed to address the unique needs of women and men.

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 642 participants or records.

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