|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Heart Attack, Bypass Patients Less Fit than
Previously Thought
Most women have
the aerobic fitness of a person with
life-threatening chronic heart failure
 June 7, 2006 People entering cardiac
rehabilitation after a heart attack or bypass surgery are not as fit as
has been assumed especially women. Women typically have the aerobic
fitness of a person with life-threatening chronic heart failure. Men in
the 2,896-patient study were more aerobically fit than women
participants but their average fitness level also proved lower than
expected.
| |
Related Stories |
|
| |
Acetaminophen May Help Pain but Not Heart after
Heart Attack
Sold as Tylenol it is
also found in Excedrin Extra Strength, Excedrin Migraine and Vanquish
May 16, 2006 Acetaminophen (Tylenol) is safe to
use as a pain reliever and fever reducer after a heart attack, but it
does not protect the heart muscle, a new study using sheep and rabbits
concluded. Read more...
Older Americans Are Sicker than Those in England
Study also concludes
income, education make a difference
May 2, 2006 After studying older people in the
U.S. and England, researchers conclude, "Americans are much sicker than
the English." Middle-aged to older U.S. residents have higher rates of
diabetes, hypertension, heart disease, heart attack, stroke, lung
disease and cancer than their English counterparts, according to the
article in the May 3 issue of JAMA.
Read more...
Read more
on
Health & Medicine |
|
Researchers determined the aerobic fitness levels
of cardiac patients when they entered an organized rehabilitation
program after a recent cardiac event that required hospitalization.
Aerobic fitness is directly related both to how well the heart can pump
and to skeletal muscle function, says the study reported in Circulation:
Journal of the American Heart Association.
I was surprised by several of our results, said
Philip A. Ades, M.D., lead author and professor of medicine and director
of Preventive Cardiology and Cardiac Rehabilitation at the University of
Vermont College of Medicine in Burlington. The biggest surprise was
how low the fitness levels were in women. The average woman in this
study fell in the fitness range where cardiologists often consider heart
transplantation in heart failure patients. The take-home message to
cardiac surgeons and interventional cardiologists is that the job is
only half-done when bypass surgery or coronary stenting is
satisfactorily performed. These patients remain sorely in need of
rehabilitation despite optimal in-hospital care.
The researchers performed exercise stress testing
with expired gas analysis in 815 women and 2,081 men who entered cardiac
rehabilitation at the University of Vermont and the Henry Ford Hospital
in Detroit from January 1996 to December 2004. Dr. Steven Keteyian,
Ph.D., led the Henry Ford research group.
The patients were hospitalized for heart attack,
bypass surgery, angioplasty or chronic angina. The average age was 61
for males and 62 for females, and most began their rehabilitation within
six weeks of leaving the hospital. The study consisted of Caucasians
(71 percent), African Americans (26 percent) and other racial groups (3
percent).
All patients underwent a treadmill test at the
start of their rehabilitation program to determine their aerobic
fitness, which is done by measuring peak oxygen consumption at their
maximum exercise level.
The treadmill test was repeated in 504 of the
Vermont patients after they completed 36 rehabilitation sessions over a
three-month period. Key study findings were:
● Men
had a significantly higher aerobic capacity than women at the start of
rehabilitation, even after adjusting for age differences.
● Aerobic capacity fell with age in men and women from the third
through the eighth decade of life, but the rate of decline was greater
in men.
● Aerobic capacity varied in men and women according to the reason for
hospitalization. Patients who underwent coronary bypass surgery had
the lowest fitness levels, followed by those who had a heart attack or
medical treatment for unstable angina. Finally, those who had a
percutaneous (administered or absorbed through the skin) coronary
intervention had the highest fitness levels.
● Race made no difference in fitness in men or women.
● The longer a person remained hospitalized, the lower his or her
aerobic capacity.
● The 504 patients tested after 36 rehabilitation sessions had an
average increase of 17 percent in aerobic capacity. Men had an average
increase of 18 percent; women had a 12 percent increase.
The smaller increase in aerobic capacity in women
came as a surprise, and we dont have a good explanation for it, Ades
said. Other studies have found that women are less fit than men when
entering rehab but they generally have shown the same relative
improvement.
Study participants probably had better aerobic
fitness than patients who failed to enter rehabilitation, he said.
Other studies have found that non-participants tend to be less healthy
and less health oriented than those who take up exercise rehabilitation.
Cardiologists use treadmill testing to assess
patients' likely longevity and risk of a future heart attack, and to
plan a safe and effective exercise program.
Unlike patients in this study who had their oxygen
consumption measured, most patients entering cardiac rehabilitation are
assessed using estimated metabolic equivalents (METS). These units are
calculated based on the peak miles per hour and percent of elevation of
the treadmill attained by patients.
The researchers discovered that calculating METS in
this way overestimated the actual METS achieved by men by 30 percent and
by women by 23 percent.
Based on their findings, the researcher developed
and published revised conversion charts, called nomograms that more
accurately indicate the peak METS attained in treadmill tests.
This study was important because there has been
little data on directly measured fitness levels in these patients, Ades
said. It also emphasizes the importance of cardiac patients doing
organized cardiac rehab, because without it the majority of these
patients would remain quite disabled.
Other co-authors are Patrick D. Savage, M.S.;
Clinton A. Brawner, B.S.; Caroline E. Lyon, M.D.; Jonathan K. Ehrman,
Ph.D.; Janice Y. Bunn, Ph.D.; and Steven J. Keteyian, Ph.D.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
