PURPOSE: To determine whether exercise at low intensity (LO; 50% of peak VO2) or high intensity (HI; 85% of peak VO2) results in improvement of the ventilatory threshold (VT), 186 men with coronary artery disease (CAD) were enrolled in an exercise study for 1 year. METHODS: A symptom-limited exercise test was performed at baseline and the heart rate corresponding to 50% and 85% of peak VO2 was determined. Subjects were randomized to LO or HI intensity exercise. Exercise sessions included 45 minutes of walking/jogging and/or stationary cycling at the appropriate target heart rate and were conducted 3 days per week. The exercise test was repeated at 3 and 6 months. Target heart rates were revised to adjust for training. RESULTS: Both LO and HI resulted in improved VO2 at VT and peak. However, HI resulted in greater improvement than LO. CONCLUSION: Among this population, both HI and LO improve the VO2 at VT and peak, but the improvement is greater with HI. The VT can be a useful adjunct to heart rate and peak oxygen uptake when prescribing exercise.

Anaerobic Threshold↗

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Obesity: a societal and cardiovascular "malignancy".

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Body Mass Index↗

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Endothelial function and cardiovascular prevention: role of blood lipids, exercise, and other risk factors.

Multifactorial risk factor modification is proven to positively influence morbidity and mortality from both cardiovascular disease and stroke. The vascular endothelium has recently been a focus of interest in cardiovascular prevention. Data suggest that vascular endothelial dysfunction may contribute to the pathophysiology of clinical ischemia, especially angina, myocardial infarction, and sudden death. Endothelial dysfunction includes abnormalities of vasomotor tone (constriction and dilation), balance between fibrinolysis and thrombosis, control of the inflammatory response, and growth of vascular smooth muscle. Cardiovascular prevention interventions have been studied extensively and there are considerable data supporting a beneficial effect on endothelial dysfunction. The interventions that are clearly effective in improving endothelial function are diet and lipid-lowering therapy (especially with statin drugs), use of angiotensin-converting enzyme inhibitors, hormone replacement therapy, vitamin E, and proper physical exercise. Many challenging issues remain unsolved, however, and the endothelium at both the molecular and cellular levels must be further investigated for both research and clinical interests.

Coronary Disease↗

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Eight steps to inpatient cardiac rehabilitation: the team effort-methodology and preliminary results.

The effects of a team approach in cardiac rehabilitation were investigated in 89 postmyocardial infarction patients. Team members followed an eight-step protocol in caring for the patients during the hospitalization phase. Risk factor modification data were collected at a mean time of 13.5 months after hospitalization. The investigated parameters included work, dietary and exercise habits, body weight, high blood pressure and cigarette smoking. Fifty-six per cent (42 of 75) of the survival group were actively working, 66 per cent (49 of 75) were adhering to a fat-controlled diet, 77 per cent (58 of 75) continued an exercise regime, 70 per cent (40 of 57) lost excess body weight, 91 per cent (21 of 23) had their blood pressure controlled and 60 per cent (27 of 45) stopped smoking cigarettes. It is concluded that an in-hospital team approach in rehabilitation of postmyocardial infarction patients is beneficial in long-term risk factor modification.

Diet↗