Age-Related Differences for Cardiorespiratory Fitness Improvement in Patients Undergoing Cardiac Rehabilitation

Jenna L. Taylor, Jose R. Medina-Inojosa, Audry Chacin-Suarez, Joshua R. Smith, Ray W. Squires, Randal J. Thomas, Bruce D. Johnson, Thomas P. Olson, Amanda R. Bonikowske

Research output: Contribution to journalArticlepeer-review


Objective: We investigated age-related differences for peak oxygen uptake (peak VO2 ) improvement with exercise training during cardiac rehabilitation (CR). Patients and Methods: This was a retrospective cohort study of the Mayo Clinic Rochester CR program including adult patients who attended CR (≥1 session) for any eligible indication between 1999 and 2017 and who had a cardiopulmonary exercise test pre and post CR with VO2 data (peak respiratory exchange ratio ≥1.0). Younger (20–49 yrs), midlife (50–64 yrs), and older adults (≥65 yrs) were compared using ANOVA for delta and percent change in peak VO2; and percentage of peak VO2 responders (>0% change). Results: 708 patients (age: 60.8 ± 12.1 years; 24% female) met inclusion criteria. Delta and percent change in peak VO2 was lower for older adults (1.6 ± 3.2−1; 12 ± 27%) compared with younger (3.7 ± 4.0−1, p < 0.001; 23 ± 28%, p = 0.002) and midlife adults (2.8 ± 3.8−1, p < 0.001; 17 ± 28%, p = 0.04). For midlife, delta change, but not percent change in peak VO2 was significantly lower (p = 0.02) compared with younger. Percentage of responders was only different between older and younger (72 vs. 86%; p = 0.008). Sensitivity analyses in non-surgical patients showed similar differences for delta change, and differences in percent change remained significant between older and younger adults (10 ± 20% vs. 16 ± 18%; p = 0.04). Conclusions: In CR patients, older adults had lower improvement in cardiorespiratory fitness than younger and midlife adults. While excluding surgical patients reduced age-related differences, older adults still had lower cardiorespiratory fitness improvement during CR. These findings may have implications for individualizing CR programming in aging populations to reduce future cardiovascular risk.

Original languageEnglish (US)
Article number872757
JournalFrontiers in Cardiovascular Medicine
StatePublished - 2022


  • exercise capacity
  • exercise training
  • older adult
  • peak VO non-responder
  • peak VO responder
  • peak oxygen uptake (VO)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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