Comparison of outcome of cardiac rehabilitation in black women and white women

Coronary artery disease is the leading cause of death among black women in the United States. Black women also demonstrate a greater prevalence of coronary risk factors and a higher mortality after myocardial infarction than white women. To evaluate the clinical profile and outcome of black women in an urban-based cardiac rehabilitation program, 35 black women (aged 54 ± 13 years) and 47 white women (aged 57 ± 10 years) were prospectively studied. Black women had similar admitting diagnoses as white women, with recent myocardial infarction being the most common (37%). Coronary risk factors were more prevalent in black women than white women in the program: hypertension (71% vs 53%; p = 0.09), diabetes mellitus (46% vs 26%; p = 0.06), obesity (74% vs 49%; p < 0.05). Cholesterol and high-density lipoprotein levels were similarly elevated in black (251 ± 53 mg/dl) and in white (248 ± 52 mg/dl) women, whereas 34% of black and 21% of white women were active smokers. There was no significant difference in initial exercise capacity at program entry. Fewer black women (51%) completed the 12-week program than white women (64%), p = NS. Comparison of initial and follow-up exercise tests after 12 weeks of moderate to high-intensity dynamic exercise demonstrated significant and similar improvements in functional capacity in both black (4.2 ± 1.6 vs 5.6 ± 1.7 METs; p < 0.001) and white (4.8 ± 2.2 vs 5.7 ±2.2 METs; p < 0.01) women. Among obese patients, only the white women lost weight. The cholesterol profile did not change in either group, and most of the smokers (74%) did not complete the program. In conclusion, black women in this program demonstrated a high coronary risk profile and low initial functional capacity, which improved after exercise training.