The aim of this study was to determine the effects of cardiac rehabilitation and exercise
training on plasma lipids, indexes of obesity and exercise capacity in the elderly
and to compare the benefits in elderly patients with coronary heart disease with benefits
in a younger cohort.
Despite the well proved benefits of cardiac rehabilitation and exercise training,
elderly patients with coronary heart disease are frequently not referred or vigorously
encouraged to pursue this therapy. In addition, only limited data are available for
these elderly patients on the benefits of cardiac rehabilitation on plasma lipids,
indexes of obesity and exercise capacity.
At two large multispecialty teaching institutions, baseline and post-rehabilitation
data including plasma lipids, indexes of obesity and exercise capacity were compared
in 92 elderly patients (> or = 65 years, mean age 70.1 +/- 4.1 years) and 182 younger
patients (< 65 years, mean 53.9 +/- 7.4 years) enrolled in phase II cardiac rehabilitation
and exercise programs after a major cardiac event.
At baseline, body mass index (26.0 +/- 3.9 vs. 27.8 +/- 4.2 kg/m2, p < 0.001), triglycerides
(141 +/- 55 vs. 178 +/- 105 mg/dl, p < 0.01) and estimated metabolic equivalents (METs)
(5.6 +/- 1.6 vs. 7.7 +/- 3.0, p < 0.0001) were lower and high density lipoprotein
cholesterol was greater (40.4 +/- 12.1 vs. 37.5 +/- 10.4 mg/dl, p < 0.05) in the elderly
than in younger patients. After rehabilitation, the elderly demonstrated significant
improvements in METs (5.6 +/- 1.6 vs. 7.5 +/- 2.3, p < 0.0001), body mass index (26.0
+/- 3.9 vs. 25.6 +/- 3.8 kg/m2, p < 0.01), percent body fat (24.4 +/- 7.0 vs. 22.9
+/- 7.2%, p < 0.0001), high density lipoprotein cholesterol (40.4 +/- 12.1 vs. 43.0
+/- 11.4 mg/dl, p < 0.001) and the ratio of low density to high density lipoprotein
cholesterol (3.6 +/- 1.3 vs. 3.3 +/- 1.0, p < 0.01) and a decrease in triglycerides
that approached statistical significance (141 +/- 55 vs. 130 +/- 76 mg/dl, p = 0.14)
but not in total cholesterol or low density lipoprotein cholesterol. Improvements
in functional capacity, percent body fat and body mass index, as well as lipids, were
statistically similar in the older and younger patients.
Despite baseline differences, improvements in exercise capacity, obesity indexes and
lipids were very similar in older and younger patients enrolled in cardiac rehabilitation
and exercise training. These data emphasize that elderly patients should not be categorically
denied the psychosocial, physical and risk factor benefits of secondary coronary prevention
including formal cardiac rehabilitation and supervised exercise training.