AUTHOR=Taylor Jenna L. , Medina-Inojosa Jose R. , Chacin-Suarez Audry , Smith Joshua R. , Squires Ray W. , Thomas Randal J. , Johnson Bruce D. , Olson Thomas P. , Bonikowske Amanda R. 

TITLE=Age-Related Differences for Cardiorespiratory Fitness Improvement in Patients Undergoing Cardiac Rehabilitation

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.872757

DOI=10.3389/fcvm.2022.872757

ISSN=2297-055X

ABSTRACT=<sec><title>Objective</title><p>We investigated age-related differences for peak oxygen uptake (peak VO<sub>2</sub>) improvement with exercise training during cardiac rehabilitation (CR).</p></sec><sec><title>Patients and Methods</title><p>This was a retrospective cohort study of the Mayo Clinic Rochester CR program including adult patients who attended CR (≥1 session) for any eligible indication between 1999 and 2017 and who had a cardiopulmonary exercise test pre and post CR with VO<sub>2</sub> data (peak respiratory exchange ratio ≥1.0). Younger (20–49 yrs), midlife (50–64 yrs), and older adults (≥65 yrs) were compared using ANOVA for delta and percent change in peak VO<sub>2</sub>; and percentage of peak VO<sub>2</sub> responders (&gt;0% change).</p></sec><sec><title>Results</title><p>708 patients (age: 60.8 ± 12.1 years; 24% female) met inclusion criteria. Delta and percent change in peak VO<sub>2</sub> was lower for older adults (1.6 ± 3.2 mL.kg.min<sup>−1</sup>; 12 ± 27%) compared with younger (3.7 ± 4.0 mL.kg.min<sup>−1</sup>, <italic>p</italic> &lt; 0.001; 23 ± 28%, <italic>p</italic> = 0.002) and midlife adults (2.8 ± 3.8 mL.kg.min<sup>−1</sup>, <italic>p</italic> &lt; 0.001; 17 ± 28%, <italic>p</italic> = 0.04). For midlife, delta change, but not percent change in peak VO<sub>2</sub> was significantly lower (<italic>p</italic> = 0.02) compared with younger. Percentage of responders was only different between older and younger (72 vs. 86%; <italic>p</italic> = 0.008). Sensitivity analyses in non-surgical patients showed similar differences for delta change, and differences in percent change remained significant between older and younger adults (10 ± 20% vs. 16 ± 18%; <italic>p</italic> = 0.04).</p></sec><sec><title>Conclusions</title><p>In CR patients, older adults had lower improvement in cardiorespiratory fitness than younger and midlife adults. While excluding surgical patients reduced age-related differences, older adults still had lower cardiorespiratory fitness improvement during CR. These findings may have implications for individualizing CR programming in aging populations to reduce future cardiovascular risk.</p></sec>