A 3D printed model of an anatomical heart. (Bill O'Leary/The Washington Post)

Cardiac rehabilitation is a medically supervised program of helping heart attack patients and those who have had heart procedures or surgeries adopt behaviors to avoid a recurrence.

These programs typically include exercise training, education and stress counseling. They usually are conducted in a clinic or hospital rehab center with input from doctors, nurses, exercise experts, physical and occupational therapists, dietitians and mental health professionals.

Yet a recent study found that in the past three decades, an estimated 80 percent of women who could benefit from cardiac rehab either didn’t go or stopped midway through, most likely because of competing work and family duties, and lack of support.

Women who don’t complete the program most often include those who were uninsured, unmarried, socioeconomically disadvantaged, smokers, depressed, obese, sedentary, elderly and nonwhite, as well as those with less education, less social support and conflicting family obligations, according to the study.

Moreover, even though evidence suggests that cardiac rehab improves depression in women, depressed women are twice as likely as others to avoid it, the study said.

“Frankly, women are great at nagging their spouses, so they make sure their partner takes their medications, goes to cardiac rehab, eats better and sees the doctor,” says Laxmi Mehta, a cardiologist with the Ohio State University Wexner Medical Center, one of the study’s authors.

“Unfortunately, many women don’t make their own personal health their priority,” she says, “which contributes to more favorable outcomes in men versus women after a heart attack. From my experience, most men attend cardiac rehab, unless work issues prevent them, or costs.”

On the other hand, she says, women, in addition to the family responsibilities and financial barriers, also can face transportation problems — it may be hard for them to get to the rehab facility — and possibly a lower capacity for exercise compared with men. “It may help to have female-specific rehab” because some women suffer from arthritis or osteoporosis, which is much less common among men, “and may fear falling off the equipment,” she adds.

The study suggests that home-based cardiac rehab might be a realistic alternative or supplement for women, with mobile phones, the Internet and other technologies possibly delivering information and services.