A recent study showed older women were less likely to enter cardiac rehabilitation than older men, due primarily to the stronger recommendations to men by their physicians. Although before entrance to programs, women were less fit than men (peak oxygen consumption 18% lower in women), both groups improved aerobic capacity similarly in response to a 12-week aerobic conditioning program.
Are there other gender-specific characteristics of myocardial infarction in women with CAD?
Non-Q-wave myocardial infarction, supraventricular arrhythmias, and infarct expansion are all more common in women, whereas pericarditis and ventricular arrhythmias are more common in men.
What cardiovascular changes are part of normal aging?
This question is a difficult one to answer because coronary artery disease is so prevalent among the elderly, affecting 50% of Americans aged 65-74 years and 60% of those 75 years. There are virtually no studies that address this question in the oldest old, those over 80. Studies which were careful to screen out underlying atherosclerotic disease indicate the following:
The heart ages well.
‚ Normal morphology changes little except for a mild increase in left ventricular wall thickness.
‚ Contractile function is well preserved.
‚ Decrease in early diastolic filling results from diminished myocardial compliance, increased isovolumic relaxation time, and sclerosis of the mitral valve.
Resting heart rate does not change.
‚ Maximum heart rate declines (about 1 beat/year due to diminished p-adrenergic responsiveness).
‚ Cardiac output in both rest and exercise is preserved.
‚ End-diastolic volume and stroke volume increase.
Arteries and veins do not fare so well.
‚ Arterial media thickens and becomes less elastic.
‚ Vascular resistance increases.
‚ Autonomic nervous system becomes less efficient.
‚ Blood pressure falls significantly on standing (baroreceptor reflex attenuated).