Rationale: While the overall body of evidence supporting participation in cardiac rehabilitation (CR) is abundant, important areas of study such as the impact of CR on the aerobic capacity of elderly patients remain underinvestigated. This question is particularly relevant as the elderly patient population represents a major proportion of those affected by cardiovascular disease.
Objectives: To assess the improvement in aerobic capacity following CR in participants who are <=70 years of age.
Methods: Nine hundred three subjects <=70 years of age and diagnosed with coronary artery disease (696 males/207 females), who were consecutively enrolled in a multidisciplinary interventional CR program at the Cardiac Wellness Institute of Calgary, were included in this analysis. Subjects underwent exercise testing to determine peak metabolic equivalent (MET) level prior to and following CR. Based on the baseline treadmill test, participants were assigned a target heart rate (40%-75% of maximal heart rate) and underwent 30 to 50 minutes of continuous aerobic activity, 3 to 5 times per week, over the course of 12 weeks.
Results: The mean age of the overall group was 74.2 +/-3.7 years. Subjects attended an average of 16.2 +/-22.9 CR sessions. Paired t testing revealed post-CR peak MET level was significantly higher in the overall group (6.7 +/-1.9 vs 7.6 +/-2.0 METs, 16.2 +/-22.9% improvement, P < .001). Improvements in aerobic capacity were consistent in males (7.0 +/-2.0 vs 7.9 +/-2.0 METs, 15.4 +/-20.8% improvement, P < .001) and females (5.7 +/-1.7 vs 6.5 +/-1.8 METs, 18.8 +/-28.6% improvement, P < .001) subgroups. Unpaired t testing revealed male subjects did demonstrate a significantly higher baseline and post-CR peak MET level compared to female subjects (P < .001). The percent improvement in peak MET level, age (male: 74.2 +/-3.8 vs female: 74.3 +/-3.4 years) and the number of CR sessions attended (male: 16.1 +/-16.0 vs female: 16.7 +/-15.0 sessions) was, however, not significantly different between subgroups (P<=.10).
Conclusion: The results of the present study indicate elderly patients with cardiovascular disease experience significant improvements in aerobic capacity following participation in CR. This trend appears to be consistent in both male and female patients. Referral to CR in eligible elderly patients should therefore be encouraged.