Rationale: The reasons for greater premature withdrawal from cardiac rehabilitation programs (CRP) in women compared with men and differences in baseline predictors of withdrawal have not been extensively studied.

Objective: Therefore, the primary objective of this study was to identify demographic (specifically age and gender), non-medical and medical factors contributing to withdrawal in a large number of consecutively enrolled women and men in a long-term CR program.

Methods: Reasons for withdrawal from a 12-month CRP in 1,089 women and 4,833 men were ascertained by interview. Regression analysis was used to determine demographic and baseline medical conditions that predicted non-completion.

Results: Non-completion was higher in women than men (35% vs 29%, P < .001), however multivariate regression revealed that gender was not the main driver of withdrawal but rather, other factors common to women at entry to CR could predict non-completion (ie, not being married, being obese, lower VO_2peak, not having previous CABG surgery, being on anti-depressant medication, and not on lipid lowering or beta blockade medication). By interview, a greater proportion of women than men withdrew for medical issues (P < .001), specifically musculoskeletal conditions (P = .002) and multiple medical problems (P = .02). A greater proportion of women withdrew for transportation (P < .001) and family issues (P = .009), while work issues affected men more than women (P = .009) as did lack of interest (P = .009). Women were more likely to withdraw than men regardless of age (P < .05).

Conclusions: Women were significantly more likely to withdraw from a CRP than men due to greater medical problems, specifically musculoskeletal and multiple medical reasons. Lack of interest and work obligations were greater barriers for men while transportation and family obligations more often affected women. Difference in withdrawal can be explained by the profile of women rather than by sex independently.