Beneficial Effect on Exercise Tolerance of a Comprehensive Rehabilitation Program in Elderly Obese Patients Affected With Heart Disease.

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.