Differences in Clinical Measures and Outcomes in South Asians vs Caucasians Attending Cardiac Rehabilitation

BACKGROUND: South Asians have a greater predisposition to cardiac events, compared to Caucasians. Although cardiac rehabilitation programs (CRPs) are known to improve outcomes, data are sparse regarding benefits acquired by South Asians vs Caucasians. The objective of the current study was to determine the outcomes of South Asian patients undergoing CRPs, compared to Caucasian patients. METHODS: This study compared baseline characteristics and outcomes in all patients attending a CRP in Edmonton, Canada with a proportionately large South Asian population. RESULTS: From 1998 to 2016, a total of 811 South Asians and 5406 Caucasians attended CRPs. Baseline characteristics revealed that there were more nonsmokers (73.4% vs 29.4%, P < 0.001), with a lower body mass index (26.8 ± 0.1 vs 29.6 ± 0.1, P < 0.001), but higher prevalence of diabetes (37.7% vs 20.5%, P < 0.001) in the South Asian population. Outcome measures revealed that South Asians spent less time in the CRP (6.9 weeks ± 0.1 vs 7.3 weeks ± 0.1, P < 0.001), attended the nutrition class less (36.2% vs 53.4%, P < 0.001), and had a lower 6-minute walk improvement (66.9 m vs 73.6 m, P < 0.001). Frequency of use of β-blockers (86.9% vs 86.1%, P > 0.05), antiplatelet agents (96.3% vs 97.1%, P > 0.05), angiotensin-converting enzyme inhibitors (79.9% vs 80.0%, P > 0.05), and cholesterol-lowering agents (91.4% vs 93.8%, P > 0.05) was not significantly different. CONCLUSIONS: Although South Asians seem to be prescribed and use proven pharmacologic treatments to the same extent as Caucasians, they appeared to benefit less from CRPs. Given higher event rates in South Asians, consideration should be given to altering the delivery of CRPs to South Asians to improve their efficacy.