Abstract
Aims: The number of elderly patients affected with multiple chronic diseases is constantly increasing. Even though multiple studies demonstrated a beneficial effect of cardiac rehabilitation, we do not have data on the outcomes in elderly patients with obesity and heart disease.Methods: We studied 772 consecutive obese subjects (275 women; 35.6%) aged ≥70 years, affected with coronary artery disease and/or heart failure. We conducted a symptom limited exercise test at the beginning and at the end of the program, which consisted of aerobic and strength physical activity, diet, and psychological counseling.Results: Mean body mass index (BMI) at baseline was 37.6 ± 4.4 kg/m2 and decreased to 36.4 ± 4.3 kg/m2 (P < 0.001). At baseline, attained metabolic equivalents (METs) were 4.7 ± 1.7, and by the end of the program, they were 5.6 ± 2.1 (P < 0.001). The mean improvement was 21.6 ± 21.7% (median, 17.6%; 95% CI, 20.0–23.1%). Patients over 80 years old had similar results compared to the younger ones. Diabetics did worse than non-diabetic patients: the improvement they reached was 19.4 ± 18.9% vs. 23.8 ± 23.9% (P = 0.005). The presence of heart failure was significantly related to both the baseline and final performance, but the attained improvement was significantly greater in heart failure patients: 24.3 ± 23.8% vs. 16.3 ± 15.4% (P < 0.001). No patient had adverse events related to the program.Conclusion: This study documents a significant improvement in exercise capacity in elderly obese patients affected with heart disease who underwent a rehabilitation program.
Highlights
Patients represent a critical issue in contemporary medicine
This study documents a significant improvement in exercise capacity in elderly obese patients affected with heart disease who underwent a rehabilitation program
Only few studies tackled the issue of rehabilitation in the obese subset of elderly subjects, and, as a consequence, little is known about the results of a rehabilitation program in obese patients in their 70s or older who are affected with coronary artery disease (CAD) and/or heart failure (HF)
Summary
Aging is a cause of disability in itself, since all organs and systems lose functionality over the years, and this is true if we consider patients affected with chronic diseases such as obesity and cardiopathy who have a high prevalence of disability [1]. Patients are at a higher risk for complications and physical deconditioning: we know that physical activity is an important contributor to the prevention of disability and favors a healthy process of aging; exercise tolerance is a very strong predictor of survival and is an available outcome of rehabilitation programs [3,4,5]. Only few studies tackled the issue of rehabilitation in the obese subset of elderly subjects, and, as a consequence, little is known about the results of a rehabilitation program in obese patients in their 70s or older who are affected with coronary artery disease (CAD) and/or heart failure (HF)
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