Recommendation for Cardiovascular Safety of Exercise in Middle-aged and Elderly People

Abstract

In order to exercise safely, proper exercise prescription based on each individual's physical fitness and health status is needed. An intensity equivalent to the ventilatory threshold level has been recommended in terms of safety of aerobic exercise, and we confirmed its safety in very elderly subjects (older than 75 years) if they had no contraindications to exercise. More than 20% of the subjects with sedentary lifestyles and lower physical fitness had deleterious symptoms such as excessive blood pressure elevation, dangerous arrhythmias, and myocardial ischemia during exercise testing. Therefore, evaluation of physical fitness level enables optimal exercise prescription for aerobic exercise in the elderly, and low-level intensity (40% of VO2max) is recommended for those subjects. Excessive blood pressure elevation was frequent in greater than 60% of 1RM lower-leg resistance exercise in the elderly subjects. Therefore, 40% of 1RM intensity is recommended in terms of safety in very elderly-aged people or those with hypertension. Proper breathing technique avoiding the Valsalva effect is effective to minimize blood pressure rise during resistance exercise. Aerobic exercise training could have a lowering effect on blood pressure rise during resistance exercise in the elderly subjects. It is noteworthy that the frequency of deleterious symptoms during exercise could not decrease after short-term aerobic exercise training in the elderly.