Effect of gender and type 2 diabetes mellitus on heart rate recovery in patients with coronary artery disease after cardiac rehabilitation

Introduction: The purpose of this study was to clarify whether type 2 diabetic patients with coronary disease are subject to similar benefits in heart rate recovery (HRR) as non-diabetic counterpatrs after cardiac rehabilitation, assessing men and women subjects separately. Material and methods: The data used for this analysis were from an eight-week, phase-II cardiac rehabilitation including 284 patients with ischaemic heart disease who were managed at Tehran Heart Centre between July 2004 and January 2006. The heart rate parameters were compared between diabetic and non-diabetic patients before and after cardiac rehabilitation. Diabetic and non-diabetic patients had similar age and left ventricular ejection fraction. Results: Among men, the non-diabetic patients achieved a greater improvement in peak heart rate and heart rate recovery (HRR). Additionally, lower resting heart rate was found in nondiabetic men after rehabilitation. In the women >= 50 years old, there was no significant difference between diabetic and non-diabetic. The non-diabetic women < 50 years old showed significantly higher peak heart rate and HRR compared with diabetic women. Conclusions: These results indicate that the benefit of cardiac rehabilitation in HRR is significantly lower in type 2 diabetic men. Improvement of HRR is not associated with diabetic status in women ? 50 years old. The response to cardiac rehabilitation in women may appear to be influenced more by age at menopause rather than diabetes mellitus. (Pol J Endocrinol 2009; 60 (6): 430-136)