ABSTRACT
The goals of cardiac rehabilitation in older coronary populations are to decrease cardiac
disability, cardiac-related symptoms, and to extend disability-free survival. Compared
with younger patients with coronary heart disease (CHD), older patients have higher rates
of disability and mobility limitations, and a diminished exercise capacity (1-3). Coronary
artery disease (CAD) in the elderly is also characterized by a greater severity of angio-
graphic disease (4), more severe and more diffuse left ventricular systolic dysfunction (5),
and increased levels of peripheral vascular and left ventricular stiffness also termed
“diastolic dysfunction,” compared with younger cardiac patients (6). The higher rate of
diastolic dysfunction results in the fact that dyspnea is a more common symptom than
chest pain in many older patients suffering a myocardial infarction (7,8). Compared with
older men, older women with CHD have a higher prevalence of chronic heart failure, a
greater prevalence of coronary risk factors, a more complex clinical course, and higher
rates of physical disability (1,9). Despite the fact that primary prevention has resulted in a
lower prevalence of CAD in the elderly, the rapidly increasing size of the older population
is such that the absolute number of older patients with CHD is increasing (10,11). Cardiac
rehabilitation exercise training designed to decrease disability and overall coronary risk in
older CHD patients should come to play an increasingly important role as the size of the
older CHD population continues to grow.
