Cardiovascular Aging and Exercise in Healthy Older Adults

OBJECTIVE: Physical inactivity in an aging population is a major contributing factor to the rising numbers of older persons with chronic illnesses and disabilities. The purpose of this article is to review the relationship between physical inactivity and age-associated changes to the cardiovascular system, and provide guidance on prescribing exercise to healthy older persons in order to mitigate the adverse effects of cardiovascular aging. DESIGN: Interpretive review of the literature. RESULTS: A number of structural and functional changes occur in the cardiovascular system with advancing age, many of which are mediated by changes in vascular stiffness. These changes lead not only to cardiovascular events and strokes, but also to frailty, functional decline, and cognitive impairment. A substantial proportion of the decline in aerobic capacity with age may result from physical inactivity. Guidelines for the prescription of aerobic, resistance, and balance training for otherwise healthy older persons are provided. CONCLUSIONS: Lack of physical activity is a major risk factor for the epidemic of chronic disease and disability facing an aging population. Many age-associated changes in cardiovascular function result from physical inactivity. The benefits of regular exercise include prevention of cardiovascular events, disability, and cognitive impairment. Age is not a contraindication to exercise, which can usually be initiated safely in older persons.