Thousands of female heart patients could be at higher risk of dying every year due to poor uptake of cardiac rehabilitation, according to new figures we have released today.
An analysis of figures in our annual National Audit of Cardiac Rehabilitation (NACR) report has revealed that in England only 43% of women eligible for cardiac rehab take it up, compared to 53% of men.
Perhaps even more troubling is the direction in which these figures are moving, with the gap widening. In the last NACR report, published this January, 44% of eligible women took part in cardiac rehab, compared to 52% of eligible men.
Rehab saves lives
Cardiac rehab has been proven to reduce a patient’s chances of further complications after a heart event, and has been shown to reduce the risk of dying from heart and circulatory diseases by 26%. Cardiac rehab also decreases hospital admissions by around 20% and leads to improvements in quality of life.
Even if they are attending cardiac rehab, women are not reaping the same benefits as male patients. They are less likely to improve their physical fitness and meet target levels for cholesterol and alcohol intake following rehab, according to the report. The charity says this is, in-part, because programmes historically offer group based rehab in a community setting which has been shown to be less attractive to women.
Ambitious targets are key
Overall, the report found that half of eligible patients are now taking up rehab. This remains well below NHS England’s 2013 ambition of achieving 65% uptake of cardiac rehab.
Last week, the BHF released its 5-point action plan for the NHS – ‘Turning Back the Tide on heart and circulatory diseases’ - stating a new ambition of reaching 85%. Reaching this goal could lead to nearly 20,000 fewer deaths and nearly 50,000 fewer hospital admissions over the next ten years as well as saving tens of millions of pounds in future care costs.
Redesigning cardiac rehab
Cardiac rehab is recommended for people after a heart attack, coronary angioplasty and heart surgery. It is also available to some people with angina or heart failure. Programmes aim to help patients understand their condition and recover from surgery by providing lifestyle advice to improve physical and psychological health – such as advice on eating healthily and exercise.
To improve uptake among women, the BHF is urging the NHS to consider an upheaval in the way in which cardiac rehab is delivered. Currently, only 10% of cardiac rehab patients are taking up home-based options, compared to 82% that are attending group-based sessions.
The report highlighted that evidence from clinical trials suggests that cardiac rehab can be delivered successfully through different approaches focused around the person rather than the service, such as through a digital or home-based programmes.
The BHF believes that offering such a solution will increase the number of people entering cardiac rehab over the next few years, and will increase uptake among underrepresented groups such as women and people from deprived and ethnic minority backgrounds. The largest gender disparity in cardiac rehab uptake was seen in the mixed white and Asian ethnic group, with 84.2% of males taking it up compared to 15.8% of females.
Speaking about the results of the report lead author Patrick Doherty, Professor of Cardiovascular Health at the University of York, said:
“These figures should be of concern to all heart patients, regardless of gender. Cardiac rehabilitation can be the difference between life and death. It could be the difference between your wife, mother, sister or daughter living a fulfilled life or struggling from the after-effects of a heart attack. It’s clear that cardiac rehabilitation is a highly effective intervention but we need to ensure it works for everyone. Adopting and promoting a digitalised approach, as part of the cardiac rehab offer, would put the patient at the forefront of the treatment. Not everybody benefits from the same form of rehabilitation, and it is imperative that these programmes reflect this.”
Radically rethinking life saving after care
Discussing the need for an upheaval of cardiac rehab, our Chief Executive, Simon Gillespie, said: “We need to radically rethink how life saving follow-up care is delivered. The current cardiac rehabilitation offer is not meeting the needs of women, robbing them of the chance to receive urgent aftercare. Patients need to be able to access help in an easy and accessible way – be that in a group setting, in their own homes or through online services.
“Redesigning cardiac rehabilitation could save thousands more lives each year and save the NHS money. But in the meantime, if you know someone who has been offered cardiac rehab, please encourage them to take it up. It could, quite literally, save their life.”
Find out more about the NACR report