Changes in cardiac structure occur with increasing age. Cardiac function is also altered, partially by the increase in blood pressure that accompanies aging. Diastolic left ventricular dysfunction, in particular, is more common in older individuals. In the elderly, maximal exercise produces a higher end-diastolic volume to achieve maximal increase in cardiac output, but the increase in ejection fraction is less than in younger subjects Also, a high proportion of apparently healthy elderly subjects, if carefully tested, are found to have occult coronary artery disease. Thus, exercise performance and testing have special considerations in the elderly. Older individuals who exercise regularly have a lower resting heart rate and blood pressure and improved fitness, balance, and gait. Those who maintain a pattern of routine exercise are at lower risk for cardiovascular events. In most cases, exercise can be recommended as an important strategy for promotion of cardiovascular health.
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