Purpose: 

Medically supervised exercise programs (MSEPs) are equally recommended for men and women with cardiovascular disease (CVD). Aware of the lower CVD mortality in women, we hypothesized that among patients attending a MSEP, women would also have better survival.

Methods: 

Data from men and women, who were enrolled in a MSEP between 1994 and 2018, were retrospectively analyzed. Sessions included aerobic, resistance, flexibility and balance exercises, and cardiopulmonary exercise test was performed. Date and underlying cause of death were obtained. Kaplan-Meier methods and Cox proportional hazards regression were used for survival analysis.

Results: 

A total of 2236 participants (66% men, age range 33-85 yr) attended a median of 52 (18, 172) exercise sessions, and 23% died during 11 (6, 16) yr of follow-up. In both sexes, CVD was the leading cause of death (39%). Overall, women had a more favorable clinical profile and a longer survival compared to men (HR = 0.71: 95% CI, 0.58-0.85; P < .01). When considering those with coronary artery disease and similar clinical profile, although women had a lower percentage of sex- and age-predicted maximal oxygen uptake at baseline than men (58 vs 78%; P < .01), after adjusting for age, women still had a better long-term survival (HR = 0.68: 95% CI, 0.49-0.93; P = .02).

Conclusion: 

Survival after attendance to a long-term MSEP was better among women, despite lower baseline cardiorespiratory fitness. Future studies should address whether men and women would similarly benefit when participating in an MSEP.

中文翻译：

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参加长期医疗监督锻炼计划后，女性死亡率低于男性

目的： 

同样建议患有心血管疾病 (CVD) 的男性和女性接受医学监督锻炼计划 (MSEP)。意识到女性的 CVD 死亡率较低，我们假设在参加 MSEP 的患者中，女性的生存率也会更高。

方法： 

对 1994 年至 2018 年间参加 MSEP 的男性和女性的数据进行了回顾性分析。课程包括有氧、阻力、灵活性和平衡练习，并进行心肺运动测试。获得了死亡日期和根本原因。Kaplan-Meier 方法和 Cox 比例风险回归用于生存分析。

结果： 

共有 2236 名参与者（66% 为男性，年龄范围 33-85 岁）参加了中位数 52 (18, 172) 次运动课程，23% 的参与者在 11 (6, 16) 年的随访期间死亡。在男女中，CVD 都是导致死亡的主要原因 (39%)。总体而言，与男性相比，女性具有更有利的临床特征和更长的生存期（HR = 0.71：95% CI，0.58-0.85； P < .01）。当考虑患有冠状动脉疾病和类似临床特征的患者时，尽管女性在基线时的性别和年龄预测最大摄氧量百分比低于男性（58% vs 78%；P < .01），但在调整年龄后，女性仍具有更好的长期生存率（HR = 0.68：95% CI，0.49-0.93；P = .02）。

结论： 

尽管女性的心肺健康基线较低，但参加长期 MSEP 后的生存率更高。未来的研究应该解决男性和女性在参与 MSEP 时是否会同样受益。