Influence of cardiovascular risk factor count on functional capacity gains in elderly patients undergoing phase 2 cardiac rehabilitation

Abstract Background Cardiac rehabilitation (CR) improves functional capacity, quality of life, and reduces cardiovascular risk. However, evidence in elderly populations remains limited. Older adults with a higher cardiovascular risk factor (CRF) burden generally have lower baseline functional capacity, yet the extent to which CRF count influences functional capacity (FC) improvement following CR remains unclear. Purpose This study aims to evaluate differences in functional capacity improvement among elderly patients with varying cardiovascular risk factor counts after completing phase II cardiac rehabilitation. Methods A cross-sectional pre-post study enrolled 161 elderly patients ( 60 years) who completed 12-session phase II cardiac rehabilitation program between Januari 2024 and June 2025. Patients were categorized into two groups: low CRF burden (≤ 1 CRF) and high CRF burden (≥ 2 CRFs). Functional capacity, expressed in metabolic equivalents (METs) using a treadmill test (TMT), was measured at baseline (T1) and post cardiac rehabilitation (T2). The change of METs (delta METs) calculated as METs(T2) minus METs(T1). Results A total of 161 patients (123 males and 38 females) completed the program, with 26.1% in the low CRF group and 73.9% in the high CRF group. The prevalence of individual CRFs was: hypertension 64%, diabetes 30.4%, dyslipidemia 62.7%, and active smoking 60.9%. Median baseline METs at T1 was 7.49 and mean METs at T2 was 9.47. The overall mean improvement in functional capacity (delta METs) was 2.17. Patients in the low CRF group achieved significantly greater improvement than those in the high CRF group (delta METs 2.76 vs. 1.97, p0.05). Conclusion Phase 2 cardiac rehabilitation is associated with significant functional capacity improvement in elderly patients, with greater gains observed in those with a lower cardiovascular risk factor burden.