IJCS | Volume 32, Nº1, January/ February 2019

24 Figure 1 - Correlation of age with heart rate, VO 2 max, metabolic equivalent (MET), and distance (m) covered in exercise stress ECG test. Baroncini et al. Ergometric test and echocardiography in the elderly Int J Cardiovasc Sci. 2019;32(1)19-27 Original Article this population must be interpreted differently than in younger individuals, since even in patients classified as low risk by risk stratification scores, an annual cardiac mortality rate of 2% was found in patients aged 75 years or older. 32,33 These findings confirm the need for specific protocols and instruments for elderly patients, 34 considering the great heterogeneity in aging process and its biological consequences. 33 In addition, considering the presence of atherosclerotic plaques in the extracranial carotid arteries in our patients, we expected its correlation with the other variables analyzed, which did not happen. In fact, its presence was previously shown to be correlatedwith systolic functions and left filling ventricular pressures,which revealed to be similar in all patients of this study. An additional important finding was the inverse correlation of the distance covered, functional capacity (METs) and VO 2 max with BMI. There is a progressive BMI increase as age advances and the prevalence of obesity has considerably increased in the elderly. 36 This has a direct impact on individuals’ health and life quality, since weight gain is associated with a decrease in functional capacity and vitality, body pain, emotional and physical problems, and increased risk for morbidity and disability. 37,38 Some limitations of the present study should be mentioned. First, the choice of the exercise protocols was made by the physician who examined the patients, based on the physical limitations of each patient. This led to the use of different ergometric protocols, making