SPC365

Cardiac rehabilitation in older populations - Never too late to improve CV health

Session: Posters (Sessão 2 - Écran 2) - Cardiologia em Populações Especiais 2
Speaker: Marta Miguez Vilela

Congress: CPC 2023
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.14 Cardiovascular Disease in Special Populations - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Marta Miguez De Freitas Vilela; Beatriz Valente Silva; Pedro Alves da Silva; Joana Brito; Catarina Simões de Oliveira; Ana Beatriz Garcia; Ana Margarida Martins; Miguel Azaredo Raposo; Catarina Gregório; João Santos Fonseca; Paula Sousa; Nelson Cunha; Inês Ricardo; Rita Pinto; Fausto J. Pinto; Ana Abreu

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Introduction</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">: Age is one of the most determinant cardiovascular risk factors and the prevalence of cardiovascular disease is higher after 70 years old. Referral to cardiac rehabilitation programs for elder individuals is often overlooked since such patients are deemed as frail, high risk and may show lack of competence when attending these programs.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Purpose</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">: To assess differences in clinical characteristics and outcomes between pts &gt;70 years old with younger ones.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Methods</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">: Prospective cohort study which included consecutive pts who were participating in a center-based CR program lasting 8-12 weeks from 2019 to 2021. We analysed prevalence of risk factors, lab echocardiographic and CPET data in women who were enrolled in the program. Statistical analysis was performed with Chi-square and Wilcoxon tests.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Results</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">: From a pool of 349 patients, only 74 (21%) were 70 or more years old. In this group most of pts were male (90,5%), mean age of 75,2 +- 4,34 year-old. 90% pts had arterial hypertension (n=67), 76% had dyslipidemia, 34% were diabetic and 57,5% were smokers or past smokers. Most patients were in NYHA II (64,2%) and the remainder in NYHA I (29,9%) and III (6%). Mean ejection fraction was 52 +- 14%. NTproBNP in first evaluation 1335 pg/mL, LDL-c 80,4 mg/dL and HDL 46,8%. Both groups (&lt;70 and &gt;70years) were relatively homogeneous, except for differences in sex (male sex mor prevalent (p=0.019) and hypertension (p=0.006).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">Interestingly there were no significant differences in both groups regarding hospital admissions, rate of reinfarction and cardiovascular death. In both groups we noted a significant improvement in echo and CPET, reaching statistical significance in ejection fraction variation (p=0.01), duration of CPET (p=0.048) workload peak; however, in contrast to younger patients, VO2 peak improvement was non significative.</span></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Conclusions</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: Although there is a higher prevalence in cardiovascular disease among older people, CR referral is far lower. As we can see, such interventions are safe and effective, also in older pts and thus we should identify factors going against their inclusion in CR programs and prioritize risk stratification.</span></span></span></p>