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Among coronary heart disease (CHD) patients, women consistently report poorer quality of life (QOL) compared to men. Unfortunately, studies that have adjusted for traditional clinical variables (eg, demographics, co-morbid and disease severity predictors) have failed to explain this gender difference. One potential variable that may partially explain this difference is physical activity (PA). Specifically, it may be that males have better QOL because they engage in significantly more PA compared to females. Although increased PA has been associated with increased QOL in CHD patients, it has not been used to specifically explain the gender difference in QOL from a mediating perspective. Furthermore, there is a paucity of data comparing QOL in men and women over extended periods of time. Therefore, the present study examined the mediating effect of PA on the gender / QOL relationship over a one year period in CHD patients.
Six hundred and four male (Mean age = 61; 36% AMI, 38% PTCA, 27% CABG) and 197 female (Mean age = 63; AMI, 37% PTCA, 25% CABG) CHD patients who participated in the TEACH trial were included in the present study. Quality of life and PA were assessed in-hospital, and 6 and 12 months after hospitalization.
Analyses of covariance indicated that males were significantly more active than females at baseline, F(1,794) = 5.81, P < .05, 6 months, F(1,795) = 12.77, P < .01, and 12 months, F(1,795) = 5.74, P < .05. Additionally males had a higher QOL than females at baseline, F(1,663) = 5.37, P < .05, and 6 months F(1,788) = 4.47, P < .05, but not at 12 months F(1,795) = 0.21, P > .05. Additionally, the Baron and Kenny mediation procedure showed that PA partially mediated the gender / QOL relationship in-hospital and at 6 months. Specifically, the male patients engaged in significantly more PA compared to females, which resulted in better QOL.
Results from the current study suggest that increased PA partially explains why males report having better QOL than females within the first 6 months after hospitalization. This suggests that future PA interventions need to focus on reducing the gender disparity in PA. In doing so, this will reduce the gender disparity in QOL as well. Therefore, the recognition of the importance of PA for female patients QOL needs to be made a central building block in cardiac rehabilitation in order for women to achieve maximal benefit from the treatment for CHD.
For more information, contact Marilyn Thomas (204) 488-5854
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