Congestive heart failure (CHF) in the elderly is a major health care problem. It afflicts over 3 million Americans, with over 400,000 new cases and 800,000 hospitalizations annually. While others are declining, CHF is the only major cardiovascular disorder that is increasing. As a result, CHF has been termed the cardiovascular epidemic of the nineties and has been designated a national research priority. Although multifactorial, the increase in CHF is largely related to the aging of the U.S. population. Among older Americans, heart failure is the most frequent hospital discharge diagnosis, is a major cause of morbid and mortal events, and consumes approximately 10 billion health care dollars per year. Most older CHF patients have diastolic heart failure, an entity that was relatively recently recognized, but that recent research suggests accounts for more than 50% of CHF in older patients. Despite the high prevalence and the substantial public health implications particularly for the elderly, few data available regarding the pathophysiology, diagnosis, prognosis, and therapy of diastolic heart failure. This entity may represent the largest cohort of cardiovascular patients that has not previously been systematically investigated. Patients with diastolic heart failure have exercise intolerance: symptoms of fatigue and dyspnea with exertion. Our research has focused on determining the causes of exercise intolerance in this population, since this is the primary chronic symptom of diastolic heart failure and can results in disability and poor quality of life. A clear understanding of the pathophysiology of this pivotal aspect is necessary in order to guide therapeutic interventions. This research study is therefore to test the benefit of exercise training in elderly with congestive heart failure. Exercise training is a program of gradually increasing stretching, walking, and stationary bicycle exercises that has been shown to significantly improve overall cardiovascular function in young and middle-aged patient with CHF. The purpose of this study is to determine whether older patients with CHF can benefit similarly.
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