Is old age a contraindication to cardiac rehabilitation after acute myocardial infarction?

Abstract

Fifty male patients older than 65 years of age (mean 66.3) underwent a symptom-limited exercise test on an average of 34 days after acute myocardial infarction. After 4 weeks of supervised rehabilitation training and after one-year follow-up, the patients underwent controlled exercise tests. The ergometric parameters were compared with respective values in 10 healthy males (mean age 66.4, range 65-75). The rehabilitation training induced a substantial improvement in physical capacity (total work from 3149 +/- 1326 to 4791 +/- 1403 kg; P less than 0.001) with a better cardiovascular response: increased maximum oxygen pulse (from 8.97 +/- 2 to 10.7 +/- 2; P less than 0.001), decreased heart rate (from 120.5 +/- 16.1 to 111.3 +/- 14.7 beats min-1; P less than 0.05) and a decreased double product at a 75 W work load (from 22 866 +/- 4005 to 20 472 +/- 3982 beats min-1 mmHg; P less than 0.05). The recovery of physical capacity and cardiovascular tolerance in the physical exercise was nearly complete as compared with healthy subjects of the same age. During the training period one patient died from heart failure. In all the other patients the same improvement was still maintained one-year later. In conclusion, old age does not seem to be per se a contraindication to cardiac rehabilitation. Physiological beneficial effects from cardiac rehabilitation can also be received by patients older than 65 years of age.

Improved physical fitness and quality of life following training of elderly patients after acute coronary events. A 1 year follow-up randomized controlled study

“…In 1985 Williams et al [2] reported that men older than 65 years increased their physical capacity and their psychological response to exertion as much as younger patients when included in a training programme initiated within 6 weeks after a myocardial infarction or coronary bypass grafting. A limitation with this and other similar studies [3,4] is that they compared the elderly with younger patients or with normal subjects in the same age-cohort [5] without any randomization [6,7] . Thus, there are no properly designed trials that have specifically addressed the efficacy and safety of exercise training in an elderly population with coronary artery disease [8] .…”

Post Hospital Depression and the Elderly Cardiac Patient

“…Until very recently in the history of cardiac rehabilitation, older patients (65 + years) were not considered appropriate candidates for vigorous exercise training following cardiac events. This attitude toward older patients was based upon the belief that older patients could not improve their cardiac status sufficiently to warrant the expense of treatment, and the fear that older patients could not be exercised safely (Opasich et al, 1984). Recent Social Work in Health Care, Vol.…”

Effects of Aerobic Group Training on Exercise Capacity, Muscular Endurance and Recovery in Elderly Patients with Recent Coronary Events: A Randomized, Controlled Study

“…Despite this, elderly patients are frequently not included in rehabilitation programmes (11), a shortcoming that probably limits their future everyday living (12). A limitation with previous studies (7,8) is that the elderly were compared with younger patients or with healthy subjects in the same age-cohort (13) and none of the studies had a randomized design (9,10,14). Thus, there is a lack of properly designed trials speci cally addressing the ef cacy and safety of exercise training in an elderly population with coronary artery disease (15).…”