Age-related differences after cardiac rehabilitation: a retrospective observational study
C Oliveira Ferreira, B Rocha, F Vilela, J Faria, S Fernandes, M Dias, I Conde, C Galvao, C OliveiraAbstract
Introduction
Cardiac rehabilitation is an essential pilar of secondary prevention in cardiovascular disease, combining exercise training and lifestyle interventions to improve functional capacity, symptom control, and quality of life. Its benefits on mortality, morbidity, and psychological well-being are well established. Despite these benefits, older adults remain consistently underrepresented in CR programs, with only about 20% of eligible patients participating. This study aimed to evaluate and compare the benefits of a cardiac rehabilitation program (CRP) between older (≥65 years) and younger (<65 years) patients.
Methods
A retrospective observational study was conducted on 124 patients who participated in the CRP between June 2017 and April 2025. Patients were stratified into two age groups: ≥65 years and <65 years. Sociodemographic, clinical analytical data and data related to exercise stress test, such as functional capacity and cardiac autonomic regulation parameters, were collected at the beginning and at the end of phase II.
Results
The cohort had a mean age of 50 ± 12 years, and 31 (25%) patients were female. At baseline, younger patients had a lower prevalence of chronic kidney disease compared with older patients (6 [6.5%] vs. 10 [32.3%], p < 0.001). Younger participants achieved higher absolute METs and chronotropic index values both before and after the CRP, whereas recovery heart rate did not differ significantly between groups. Following rehabilitation, both groups demonstrated significant improvements in METs (younger: 8.805 → 9.632, p < 0.001; older: 6.015 → 7.522, p < 0.001) and in exercise endurance (younger: 7:54 → 8:51 min, p < 0.001; older: 4:51 → 6:34 min, p < 0.001). The relative improvement in METs was greater among older patients (1.222 vs. 0.826, p = 0.018). Improvement in NYHA functional class was significant in the younger group (p = 0.021) but not in the older group (p = 0.276).
Conclusion
Participation in a structured cardiac rehabilitation program significantly improved exercise capacity and endurance in both younger and older patients. Older patients have shown a higher improvement in their functional capacity exercise test when compared to younger patients, without significantly improving their NYHA classification.