Introduction: Cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) remains underutilized especially among older patients. While CR benefits are well established among middle-aged individuals, outcomes are less well documented in older patients. Research that specifically targets the older population is necessary to guide more effective interventions that will promote achievement of secondary prevention goals in this population.

Purpose: The purposes of this study were to (1) compare baseline clinical characteristics between younger and older patients completing CR and (2) examine changes in these characteristics at CR completion within and between groups.

Design: The design was a retrospective analysis of patients completing CR in an academic medical center.

Method: Data from patient records (n = 685, 29% women, 29% non-white) collected between January 1996 and March 2007 were examined. Comparisons were made between "younger" (< 65 years of age, n = 383) and "older" patients (= 65 years of age, n = 291) for baseline characteristics, changes in selected measures during CR, and the proportion of patients at treatment goals before and after CR. Sub-analyses were conducted between "young-old" (65-74 years of age, n = 226) and "old-old" (=75 years of age, n = 71). General linear regression modeling was used to determine the effect of age on outcomes.

Results: At baseline, older patients were less obese, had lower LDL and non-HDL cholesterol, lower hemoglobin A1C (when diabetes was present) and lower Beck Depression Inventory (BDI-II) scores (all P < .05), but had higher blood pressures, more co-morbidities, and poorer functional capacity by 6-minute walk distance (all P < .05). At CR completion, improvement (P < .05) was achieved among younger patients for all measures except for HDL-C and among older patients for all measures except diastolic blood pressure and HDL-C. Similar improvements from baseline to CR completion were evident among the "old-old." When comparing younger and older patients, older patients had lesser improvement in peak exercise intensity, 6-minute walk distance, diet score, and systolic blood pressure, but greater improvement in the mental component score of the SF-36 after taking into account gender, race, number of sessions attended, and baseline value for each variable.

Conclusions: Older patients with CHD entered CR with less adverse risk factors but more co-morbidities compared with younger patients. Both groups exhibited significant improvements by CR completion and these improvements extended to the oldest patients. The study illustrates the benefits of CR and encourages clinicians to regularly refer and enthusiastically promote CR among older patients.