Effect Of Smoking On The Rehabilitation Of Elderly Male Patients With Coronary Heart Disease

Objective: To explore the effect of smoking on rehabilitation in older male patients with coronary heart diseaseMethod: Thirty-three male patients with coronary heart disease based on smoking or not were divided into two groups. According to number of cigarettes smoking, the smoking group was further divided into two sub-groups, relatively mild(￡20/day) and severe(>20/day) smoking. Then, the subjects undertook a graded exercise test, and the metabolic equivalents(METs), VO2 pk appearing time, heart rate(HR), blood pressure(BP), heart rate variability(HRV) including low-frequent power(LF), highfrequent power(HF), low power high frequent power ratios(LF/HF) and total power(TP), and ST segment(ST) were measured before, during and after the tests. After that all patients participated an exercise based cardiac rehabilitation program for 12 weeks. Each subject was then re-tested using the same protocol and intensity.Result:(1)A non significant difference existed between the two groups for METspk, VO2 pk appearing time measured pre the program. A non significant difference existed between the two smoking subgroups for METspk, VO2 PK appearing time measured pre the program. A significant difference existed between the two groups for METspk, VO2 pk appearing time measured post the program(P<0.05), METspk and VO2 pk appearing time of the two groups increasing significantly(P<0.05,P<0.01) post the program compared with those measured pre the program. METspk and VO2 pk appearing time of the two smoking subgroups increasing significantly post the program compared with those measured pre the program(P<0.05,P<0.01).(2)The BP at rest decreased significantly(P<0.05,P<0.01) and the HRpk during the exercise test increased significantly(P<0.05,P<0.01) for both groups post the program compared with that measured pre the program. A significant difference existed between the two groups for BP at rest and HRpk during the exercise test measured post the program(P<0.05). BPpk of the two groups showed an increasing tendency post the program.(3)During the exercise test, the ST segment depression improved significantly(P<0.05,P<0.01), and RPPpk increased significantly(P<0.05, P<0.01) post the program compared with those measured pre the program. A significant difference(P<0.05) existed between the two smoking subgroups for ST segment depression and PRRpk measured post the program. A significant difference existed between the two groups for PRRpk during the exercise test measured post the program.(4) A non significant difference existed between the two groups for LF, HF,TP and LF/HF measured at rest pre the program.(5)The LF and LF/HF showed an increasing tendency for both groups after the exercise test pre the program, whereas the HF and TP demonstrated a decreasing tendency at the same time.(6)The HF and TP of the two groups increased significantly(P<0.05, P<0.01) at rest post the program compared with those measured pre the program, however the positive effect of this change in smoking group was inferior to that of non smoking group(P < 0.05). This tendency was also observed between the two smoking subgroups(P<0.05), with the severe smoking subgroup showing less positive effect.(7)Compared with values measured pre program, the HF increased significantly(P<0.05, P<0.01) and the LF/HF decreased significantly(P<0.05, P<0.01) after the exercise test post program for both groups. Again, smoking compromised this positive effect in HF changing, and a significant difference in HF was observed both between the two groups(P<0.05), and between the mild and severe smoking subgroups(P<0.05).Conclusion: The function of aerobic working capacity, cardiac function and autonomic nervous function in patients with coronary heart disease can be improve through a 12-week exercise based cardiac rehabilitation program, but the recovery effects will be compromised by continuing smoking.