The association of tobacco use and gender to cardiac rehabilitation outcomes: a preliminary investigation

Abstract

Introduction: Cardiac rehabilitation (CR) outcomes are measured in terms of cardiovascular disease (CVD) risk factor reductions, and these predict long-term cardiac status. This report examines whether reported tobacco use has differential effects on successful cardiovascular risk factor modification, especially for women who have greater smoking-related CVD consequences than men. Methods: A retrospective cohort analysis was conducted on 1138 adults (74% male) with diagnosed CVD who participated in ≥7 weeks of a comprehensive CR program. Eleven CVD risk factors were assessed at CR entry and completion. Tobacco use was assessed by self-report at CR entry. The primary outcomes were attainment of goal levels for each risk factor. Results: Fewer current and former tobacco users reached the preset goal for maximal exercise capacity. Fewer women than men reached the preset goal for high-density lipoprotein cholesterol (HDL). Women who were current or former tobacco users were less likely to meet the target goals for triglycerides and more likely to meet target goals for total cholesterol and non-HDL cholesterol. Conclusions: This preliminary study suggests the importance of identifying the effect of tobacco use and gender on CR outcomes and the need to evaluate modification of key cardiovascular risk factors for subgroups of cardiac patients.

• Tobacco use
• gender
• cardiovascular disease
• cardiovascular rehabilitation

Acknowledgements

This work was supported by the National Institutes of Health (R03-DA027052 to A.H.W., P50-DA033945 [ORWH & NIDA] to S.A.M.); Women’s Health Research at Yale; the Yale Cancer Center; the State of Connecticut, Department of Mental Health and Addiction Services; and the McConnell Heart Health Center Research Fund.

The authors thank Michelle LaLonde and Kathy Spencer for their contributions to this work.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.