The aim of this prospective study was to compare the effects of an ambulatory cardiac rehabilitation program on anxiety and depression between women and men.

Eight hundred ninety-three patients, 256 women and 637 men, with identical age group (56 and 55 years, respectively) were included in the study. All patients performed a 6-week multidisciplinary holistic cardiac rehabilitation program including exercise training, psychological screening and support as well as education concerning lifestyle. Reasons of admission were coronary heart disease artery bypass graft surgery (41%), angioplasty percutaneous coronary interventions and stent (25%), angor pectoris or myocardial infarction (8%), aortic or mitral valve replacement or repair (13%), dilated cardiomyopathy (4%), other (9%). Levels of anxiety and depression were measured by the psychologist using the Hospital Anxiety and Depression (HAD) scale, before and after the cardiac rehabilitation program.

At baseline, women had a significant higher score for anxiety (11.24 vs 9.02, P < .001) with a higher prevalence of anxiety (HAD <= 11) (57% vs 34%, P < .001) than men. Women had also a significant higher score for depression (7.39 vs 5.91, P < .001) with a higher prevalence of depression (HAD <= 8) (44% vs 31%, P < .001).

At the end of the program, the entire population studied achieved significant improvements characterized by a statistically significant fall in anxiety/depression (HAD scale). However, mean fall for anxiety was significantly higher in women (-36% vs -28%, P<.05) as compared to men. Identical trends was found for depression (-54% vs -41%, P < .05). Consequently, prevalence of anxiety [HAD<= 11] (18% vs 14%, P = .059) and depression (HAD <= 8) (9% vs 9%) were similar in women and men at the end of the rehabilitation.

Conclusions: In our study, at baseline, women had a higher level of anxiety and depression than men. A holistic rehabilitation program including psychological screening and support is able to reduce significantly the level of anxiety and depression in both women and men. However, women achieved higher improvement. Consequently, at the end of the program, women and men had a similar prevalence for anxiety and depression.