Risk factors seen in young heart disease patients

By Will Boggs, MD

NEW YORK (Reuters Health) - Heart disease patients younger than 55 years of age can benefit substantially from cardiac rehabilitation and exercise training (CRET) programs, according to a report in Archives of Internal Medicine.

"Young coronary patients have a very abnormal risk profile, characterized by more obesity, (high cholesterol), and much higher psychological distress," Dr. Carl J. Lavie from the Ochsner Medical Center in New Orleans told Reuters Health. "All of these parameters, as well as many other aspects of the risk profile, markedly improve following formal CRET, including 50 to 80 percent reductions in the (rate) of these abnormal behavioral patterns."

Lavie and Dr. Richard V. Milani investigated psychological and overall risk profiles in younger patients with heart disease, compared them with those of older patients (at least 70 years of age), and evaluated the effects of formal CRET programs in the younger patients following a heart attack or related event.

Compared with the older patients, the younger ones were more likely to be overweight and have higher cholesterol levels, but they had lower blood pressure, the authors report.

Younger patients also had higher scores for depression, hostility, and anxiety.

After CRET, young patients showed significant improvements in body weight, cholesterol levels, breathing, heart rate, and blood pressure, the results indicate.

Young patients also experienced marked improvements in anxiety, depression, hostility, and quality of life after CRET, the researchers note.

Elderly patients experienced similar, but less marked, improvements in most variables studied, the report indicates.

"These data support the importance of getting young patients following major cardiac events to be routinely referred to and vigorously encouraged to attend these CRET programs," Lavie said.

"I believe that these data provide further support for the benefits of exercise training to improve overall psychological health," Lavie added. "We are currently evaluating the impact that these psychological factors have on mortality and whether this can be affected by reducing these adverse factors with CRET."

SOURCE: Archives of Internal Medicine, September 25, 2006.