Abstract 12528: Risk Factor and Exercise Capacity Metrics Improve Less in African Americans, Particularly Women, Following Cardiac Rehabilitation

Abstract

Background Cardiac rehabilitation (CR) is of benefit in patients with coronary artery disease (CAD). Most studies have focused on CR in Caucasians and data for African-American populations are sparse. We hypothesized that risk factors and exercise capacity would improve with CR regardless of race.

Methods 1140 patients (158 African Americans and 982 Caucasians, aged 59±12 vs 63±12 years respectively, p<0.05) were enrolled in a structured 36-session program of CR for CAD or post-cardiac surgery. Patients received counseling on nutrition and lifestyle. Risk factors and metabolic equivalents (METs) levels were metrics measured before and after CR.

Results At baseline, mean (±sd) body mass index and percent prevalence of obesity were higher in African-American females (33±8, 61%) than African-American males (27±6, 22%), Caucasian females (29±7, 31%) and Caucasian males (28±5, 30%), p<0.05. After CR, body mass index remained unchanged in all African Americans, but fell in Caucasians (see table). Weight, blood pressure, HDL, and triglycerides remained unchanged in African-American females following CR. MET levels rose less in African-American females than in all other groups (see figure).

Conclusion Obesity is a particular problem in African-American women entering CR. Following CR, greatest benefit was seen in Caucasians, especially men who improved in all 11 metrics. In contrast, while African Americans did benefit, this was less than Caucasians, and was poorest in African-American women who improved in only 3 metrics.