Exercise therapy for older persons with cardiovascular disease

Cardiac rehabilitation with exercise training after myocardial infarction in persons younger than 70 years has been found to cause a significant decrease in all-cause mortality, cardiovascular mortality, and fatal reinfarction, but no significant difference in nonfatal reinfarction. After myocardial infarction or coronary revascularization in older individuals, such programs significantly improve physical work capacity, body mass index, percent body fat, serum lipids, behavioral characteristics, and quality of life. Exercise modalities should include aerobic, resistance, and flexibility exercises. Less intense exercise of longer duration should be performed by older persons with coronary artery disease. Exercise training programs in patients with congestive heart failure produce significant improvement in peak oxygen consumption, exercise duration, and power output. The benefits of exercise training in patients with congestive heart failure may be due to an increase in cardiac output, an improvement in skeletal muscle metabolism, and an increase in peak blood flow to the exercising limb caused by a reduction in vascular resistance.