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Levels of homocysteine are inversely associated with cardiovascular fitness in women, but not in men: data from the National Health and Nutrition Examination Survey 1999-2002.

OBJECTIVES: Cardiovascular fitness represents the ability of active skeletal muscle to utilize oxygen during aerobic exercise. Elevated homocysteine, causing tissue injury by such mechanisms as oxidative stress, endothelial damage, and protein homocysteinylation, is associated with increased risk of cardiovascular disease, dementia and osteoporotic fracture. However, the association between elevated homocysteine and cardiovascular fitness has not been reported. DESIGN: Population-based cross-sectional study. SETTING: National Health and Nutrition Examination Survey from 1999 to 2002 in the USA. SUBJECTS: A total of 1444 noninstitutionalized adults aged 20--49 years with reliable measures of cardiovascular fitness and non-missing values in homocysteine. Main outcome measures. Cardiovascular fitness, estimated maximal oxygen uptake or VO(2)max (mL kg(-1) min(-1)), was obtained by a submaximal exercise test. Levels of homocysteine were measured by the Abbott homocysteine assay, a fully automated fluorescence polarization immunoassay method and were natural-log-transformed due to right skewness. RESULTS. After adjustment for age, race and body mass index, there was a 0.70 mL kg(-1) min(-1) decrease (P=0.033) in the estimated VO(2)max for each standard deviation (SD) increase in the natural-log-transformed homocysteine level for women. Additional adjustment of hypertension, diabetes, smoking status, alcohol intake, use of lipid-lowering agents, physical activity, self-report health condition, as well as levels of folate, vitamin B(12), creatinine, C-reactive protein, total cholesterol and haemoglobin seemed to influence the association. In the fully adjusted model, we observed a 1.18 mL kg(-1) min(-1) decrease (P=0.003) in the estimated VO(2)max for each SD increase in the natural-log-transformed homocysteine level in women. There was no association between cardiovascular fitness and homocysteine levels in men. CONCLUSION. High homocysteine levels were inversely associated with cardiovascular fitness in women, but not in men. The results suggest that homocysteine levels are important indicators of exercise tolerance amongst women and may be useful in targeting female individuals requiring endurance intervention to prevent loss of cardiovascular fitness and function.

Adult↗

Aerobic fitness and the cardiovascular response to stress.

The observation that aerobically fit persons react to physical load with a smaller sympathetic response than do less fit subjects suggests that their response to psychological stress might also be reduced. The evidence for this, however, is far from consistent. It was argued that this inconsistency might be due to the incomplete measurement of the response system involved. In the present experiment two groups, which differed strongly in maximal aerobic power, were compared with respect to their cardiovascular response to a laboratory stressor. In addition to the traditional heart rate and blood pressure measurements, pre-ejection period, cardiac output, and peripheral resistance were assessed. Since only the part of the stress response that is not accounted for by metabolic needs might have pathological significance, the so-called "additional" responses were also measured. Fitness was shown to be associated with smaller sympathetic effects on both heart and vessels. The decrement in pre-ejection period and the heart rate response were smaller in the high fit group. The total peripheral resistance and diastolic blood pressure responses pointed to a much stronger vascular reactivity in the low fit group. Unexpectedly cardiac output did not increase during stress. The strong heart rate response in the low fit group was compensated by a reduction in stroke volume, which probably originated in an increased peripheral resistance. The largest discrepancy between the effects of sympathetic activation during stress and exercise occurred in the vessels, as demonstrated by the large "additional" response in total peripheral resistance during stress. The data point to the often neglected role of vascular processes in experiments of this kind. Furthermore, it seems necessary to take the effect of fitness into account when comparing subjects with respect to their cardiovascular stress response.

Adolescent↗

Aerobic fitness and opioidergic inhibition of cardiovascular stress reactivity.

The role of endogenous opioids in aerobic fitness-induced decrements in cardiovascular stress reactivity was examined by comparing the effects of opioid antagonism with naltrexone on responses to stress in young adults with high versus low levels of aerobic fitness. Two hundred forty subjects were given an activity questionnaire and males with the highest (Fit) and lowest (Nonfit) aerobic activity profiles were recruited for maximal oxygen consumption (VO2max) treadmill testing and psychological stress testing (final sample N = 28). Heart rate and blood pressures were measured during performance on a computer-controlled arithmetic task after pretreatment with either naltrexone (Trexan, DuPont) or a placebo. During placebo challenges, Fit subjects, compared with Nonfit, showed lower heart rate reactivity during stress and lower mean arterial blood pressures immediately before and during recovery from stress. Naltrexone eliminated these reactivity differences by increasing heart rate reactivity and raising mean arterial blood pressure in Fit subjects. These data suggest that aerobic fitness is associated with enhanced opioidergic inhibition of circulatory stress reactivity. Opioidergic modulatory effects on stress reactivity may comprise an important mechanism in fitness-associated risk reduction for cardiovascular disease.

Adult↗

Physical activity and physical fitness as protection against premature disease or death.

It is known from prospective studies that the incidence of coronary heart disease (CHD) is lower in the physically active compared with the sedentary part of the population, and the rate of CHD is lower with higher fitness level. In studies where both physical activity (PA) and fitness are assessed, only fitness, and not PA, appear to be an independent predictor of mortality from CHD. It is unclear whether other fitness components than maximal oxygen uptake (Vo2max) have a beneficial effect on the rate of CHD. Further, it seems likely that there is an upper threshold of fitness (Vo2max) above which no further improvement in risk factors for CHD is found. However, most middle-aged people have fitness levels below this threshold. There is no doubt that the middle-aged sedentary person benefits from physical activity regardless of type and intensity, and it may be easier to motivate a sedentary person to carry out moderate physical activity. However, it is likely that the best effect is achieved by performing physical activity of a type and intensity sufficient to improve the fitness level. Still, recommendations of type, frequency, duration and intensity are matters of debate.

Coronary Disease↗

National physical education curriculum: motor and cardiovascular health related fitness in Greek adolescents.

BACKGROUND: State school physical education (PE) programmes are common throughout Greece. However, it is not known if the main objectives of the Greek PE curriculum are achieved. OBJECTIVE: To assess the current national PE curriculum in relation to selected motor and cardiovascular health related fitness parameters. METHODS: A sample of 84 Greek schoolboys (mean (SD) age 13.6 (0.3) years, height 160.7 (8.6) cm, weight 50 (10.8) kg) volunteered. Forty three indicated participation only in school PE classes and habitual free play (PE group). The remaining 41 were involved in extracurricular organised physical activities in addition to school PE and habitual free play (PE+ group). The subjects underwent anthropometric, motor (flexibility, balance, standing broad jump, hand grip, sit ups, and plate tapping), and cardiovascular health related (percentage body fat, aerobic fitness, and physical activity) fitness assessments. RESULTS: Children in the PE group had inferior motor and cardiovascular health related fitness profiles compared with those in the PE+ group. Body fat (20.3 (8.8) v 13.9 (3.5); p<0.001), aerobic fitness (34.7 (3.7) v 43.9 (4.2); p<0.001), and time spent in intensive physical activity (0.2 (0.2) v 0.7 (0.3); p<0.001) showed the greatest differences between the two groups. In the pupils in the PE group, these were lower than the levels proposed to be necessary to combat future health risks. Adjustments for confounding variables showed a decrease in the significance of motor fitness, but not in cardiovascular health related parameters. CONCLUSIONS: The national PE curriculum for Greek secondary schools does not achieve the required levels of motor and cardiovascular health related fitness and should be reconsidered.

Adolescent↗

The Tromsø study: physical fitness, self reported physical activity, and their relationship to other coronary risk factors.

STUDY OBJECTIVE: The aim was to investigate the associations between physical fitness, leisure physical activity, and coronary risk factors. DESIGN: This was a cross sectional study of a random sample of men and women, following a population survey. SETTING: The municipality of Tromsø, Norway in 1986-1987. PARTICIPANTS: All men born 1925-1966 and all women born 1930-1966 were invited to the survey; 21,826 subjects attended (81% of the eligible population): of these, 297 men and 312 women, randomly selected, attended the present study (attendance rates 94% in men and 89% in women). MEASUREMENTS AND MAIN RESULTS: Fitness was tested by bicycle ergometry. Physical activity was reported on a questionnaire. Multiple regression analysis was performed with fitness and leisure activity as dependent variables, and coronary risk factors as independent variables. Fitness and leisure activity were positively related (p less than 0.05). Prominent findings for fitness were negative associations with age and smoking (p less than 0.05), and positive associations with body mass index in both sexes (p less than 0.01). HDL cholesterol and systolic blood pressure were significant predictors of fitness in men (p less than 0.01). Smoking emerged as a strong negative predictor for leisure activity in women (p less than 0.01), and a negative relation between leisure activity and total cholesterol was found in men (p less than 0.01). CONCLUSIONS: The study indicates that coronary risk factors are more closely linked to physical fitness than to leisure physical activity.

Adult↗

Physical activity, physical fitness, blood pressure, and fibrinogen in the Northern Ireland health and activity survey.

STUDY OBJECTIVE: To investigate the relationship between physical activity, physical fitness, blood pressure, and fibrinogen. DESIGN: This was a cross sectional population study using a two stage probability sample. SETTING: Northern Ireland. PARTICIPANTS: A sample of 1600 subjects aged 16-74 years from the population of Northern Ireland. MAIN OUTCOME MEASURES: Physical activity profile from computer assisted interview using the Allied Dunbar national fitness survey scales. Physical fitness using estimation of VO2 max by extrapolation from submaximal oxygen uptake while walking on a motor driven treadmill. Systolic and diastolic blood pressure measured with a Hawksley random zero sphygmomanometer. Measurement of fibrinogen using the Clauss method. MAIN RESULTS: There were significant relationships between both current and past activity and blood pressure. These were of a magnitude that would have been clinically significant, but for the fact that, with the exception of the relationship between habitual activity and diastolic pressure (p = 0.03) and past activity and systolic pressure (p = 0.03) in men, they were not sustained after adjustment for the effect of age using analysis of variance. After adjustment for other potentially confounding factors using multiple regression, there was an inverse relationship between systolic blood pressure and past activity in men, so that those with a life-time of participation compared with a life-time of inactivity had a lower systolic blood pressure of 6 mmHg (p < 0.05). There was a highly significant (p < 0.001) inverse association between both systolic and diastolic blood pressure and physical fitness (VO2 max) which was not sustained after adjustment for possible confounding factors. There were relationships between fibrinogen and highest recorded activity (p < 0.001), habitual activity (p < 0.01), and past activity (p < 0.01) in men but no significant relationship in women. The relationship between fibrinogen and activity was no longer sustained after adjustment for possible confounding factors. There was a highly significant (p < 0.001) inverse relationship with physical fitness using VO2 max. This relationship was sustained after adjustment for possible confounding factors in both men (p < 0.05) and women (p < 0.001). CONCLUSIONS: There was a relationship between physical activity, physical fitness, and blood pressure but the relationship was greatly influenced by age. A reduction of 6 mmHg in systolic blood pressure associated with past activity is of clinical significance and supports the hypothesis that physical activity is of benefit in reducing cardiovascular risk. There was a lower level of fibrinogen in those who were most active but this relationship was not significant after adjustment for possible confounding factors. There was also a lower level of fibrinogen those who were most fit (VO2 max) and this relationship persisted even after adjustment for possible confounding factors.

Adolescent↗

Age, fitness, and regional blood flow during exercise in the heat.

During dynamic exercise in warm environments, the requisite increase in skin blood flow (SkBF) is supported by an increase in cardiac output (Qc) and decreases in splanchnic (SBF) and renal blood flows (RBF). To examine interactions between age and fitness in determining this integrated response, 24 men, i.e., 6 younger fit (YF), 6 younger sedentary (YS), 6 older fit (OF), and 6 older sedentary (OS) rested for 50 min, then exercised at 35 and 60% maximal O2 consumption (VO2max) at 36 degrees C ambient temperature. YF had a significantly higher Qc and SkBF than any other group during exercise, but fitness level had no significant effect on any measured variable in the older men. At 60% VO2max, younger subjects had significantly greater decreases in SBF and RBF than the older men, regardless of fitness level. Total flow redirected from these two vascular beds (deltaSBF + deltaRBF) followed YF >> YS > OF > OS. A rigorous 4-wk endurance training program increased exercise SkBF in OS, but deltaSBF and deltaRBF were unchanged. Under these conditions, older men distribute Qc differently to regional circulations, i.e., smaller increases in SkBF and smaller decreases in SBF and RBF. In younger subjects, the higher SkBF associated with a higher fitness level is a function of both a higher Qc and a greater redistribution of flow from splanchnic and renal circulations, but the attenuated splanchnic and renal vasoconstriction in older men does not appear to change with enhanced aerobic fitness.

Adult↗

Cerebral blood flow responses to severe orthostatic stress in fit and unfit young and older adults.

BACKGROUND: Animal models suggest that aging negatively affects the cerebral blood flow (CBF) response to a hypotensive challenge while research with humans suggests that chronic physical activity may positively affect age-associated alterations in CBF. The extent to which chronic exercise affects the CBF responses to orthostatic stress in older subjects is unknown. OBJECTIVES: The purpose of this study was to determine the extent to which differences in age and cardiovascular fitness, reflective of differences in chronic exercise training, affect cerebral blood flow responses to severe orthostatic stress. METHODS: Subjects were divided into four groups: old fit (OF; 72 +/- 2 year-olds; 38.7 +/- 1.6 ml.kg(-1).min(-1)), old unfit (OU; 71 +/- 1 year-olds; 27.7 +/- 2.9 ml.kg(-1).min(-1)), young fit (YF; 23 +/- 0.5 year-olds; 56.1 +/- 1.8 ml.kg(-1).min(-1)) and young unfit (YU; 23 +/- 1 year-olds; 41.1 +/- 1.6 ml.kg(-1).min(-1)). Fitness was quantified with maximal graded exercise testing. Middle cerebral artery blood flow velocity (CBF velocity; transcranial Doppler) responses to graded orthostatic stress (lower body negative pressure) to presyncope were assessed. RESULTS: Orthostatic tolerance did not differ between groups (p = 0.633). The groups differed in fitness (YF >YU = OF >OU; p < 0.001) but not in either resting CBF velocity (p = 0.364) or pulsatility index (PI; p = 0.251). CBF velocity decreased below rest in the last completed stage of submaximal LBNP (p < 0.001) but did not differ between groups (p = 0.182). PI did not change with submaximal LBNP within groups. At presyncope, mean CBF velocity decreased below that of the last completed stage of LBNP in all groups (p < 0.001) while the PI increased in the young fit group only (p < 0.001). CONCLUSION: Marked differences in age and fitness did not affect cerebral blood flow responses to severe orthostatic stress. While severe orthostatic stress can compromise CBF velocity in all age groups, older adults appear to autoregulate CBF as well as much younger subjects.

Adult↗

Exercise fitness, cardiac work and blood viscosity factors in patients and normals.

A study of 41 cardiovascular patients and normals showed significant correlations between physical fitness (as expressed by a fitness index based on work output) and high shear rate blood viscosity (p less than 0.01); between the cardiac work expressed as double product (= myocardial oxygen demand) and aggregation of red cells (p less than 0.05); between the triple term of cardiac work (fitness index divided by double product) and high shear rate blood viscosity (p less than 0.005) or aggregation of red cells (p less than 0.05), in all cases correlations being negative i.e., higher cardiac work or higher fitness being related to low blood viscosity or lower aggregation of red cells. Significant differences were found between high-fitness and low-fitness groups, the high-fitness group showing from plasma viscosity (p less than 0.0005), lower fibrinogen level (p less than 0.05), and higher albumin/fibrinogen ratio (p less than 0.01).

Adult↗

Cardiorespiratory fitness, physical activity, and arterial stiffness: the Northern Ireland Young Hearts Project.

Poor cardiorespiratory fitness and low physical activity have been identified as determinants of greater arterial stiffness, a mechanism that can partially explain the association of both variables with increased cardiovascular disease. However, the nature of these associations are not clear because cardiorespiratory fitness and physical activity can both mediate and confound the associations of one another with arterial stiffness. This issue was therefore examined in a population-based cohort of young adults. Subjects included 405 young men and women participating in an ongoing longitudinal study, the Northern Ireland Young Hearts Project. Pulse wave velocity was used to determine arterial stiffness in 2 arterial segments (aortoiliac and aortodorsalis pedis) using a noninvasive optical method. Cardiovascular fitness was estimated with a submaximal cycle test of physical work capacity and physical activity was estimated using a modified Baecke questionnaire. Associations were investigated with the use of multiple linear regression models with adjustment for potential confounders and/or intermediate variables. Cardiorespiratory fitness and sports-related physical activity (but not leisure- and work-related physical activity) were inversely associated with arterial stiffness in young adults. The associations between sports-related physical activity and arterial stiffness were strongly mediated by cardiorespiratory fitness, whereas physical activity levels did not disturb the associations between cardiopulmonary fitness and arterial stiffness. These findings suggest that arterial stiffness-related benefits of exercise are most likely to accrue if exercise prescription in young adults targets improvements in cardiorespiratory fitness.

Adult↗

Autonomic responses of women with parental hypertension. Effects of physical activity and fitness.

We studied the moderating effects of cardiorespiratory fitness and physical activity on heart rate and blood pressure responses to psychophysiological stressors and the carotid-cardiac baroreflex in young normotensive women with a parental history of hypertension (n = 31). Testing occurred during the follicular menstrual phase. Subjects were divided into high versus moderate (46.6 +/- 6.5 versus 35.9 +/- 1.9 mL.kg-1.min-1) VO2peak and high versus moderate (1217.7 +/- 98.4 versus 1015.5 +/- 49.4 J.kg-1.wk-1) physical activity groups. The groups did not differ in heart rate or blood pressure responses to mental arithmetic or the cold-face test. However, the highly fit women had longer maximal R-R intervals compared with the moderately fit women when the carotid-cardiac baroreflex was stimulated by negative pressures applied to the neck during resting conditions (P < .01). The carotid-cardiac baroreflex was attenuated during mental arithmetic compared with rest in both the moderately fit and moderately active women but not in the highly fit and highly active groups. We find no evidence that aerobic fitness reduces sympathetic responses to laboratory stressors in young women with parental hypertension. Our findings are consistent with greater parasympathetic tone during sympathetic challenge for the highly fit and highly active subjects. Clarification of autonomic balance during carotid baroreflex stimulation at rest and during sympathetic challenge after exercise training would provide important information regarding mechanisms that regulate cardiovascular responses to autonomic challenge in women at risk for hypertension.

Adult↗

Blood pressure and physical fitness in children.

The association between physical fitness and blood pressure was studied in 2061 children selected from all fourth graders in 44 elementary schools in the New York City area. Their blood pressure and physical fitness were measured on two consecutive examinations 1 year apart. Systolic and diastolic blood pressure were highest in children with poor physical fitness. The change in physical fitness between the 2 examination years was related to the change in systolic and diastolic blood pressure (i.e., children with a decline in physical fitness showed the largest rise in blood pressure). These observations suggest that the level of systolic and diastolic blood pressure in children is associated with the level of physical fitness. They also indicate that change in blood pressure in childhood may be related to change in physical fitness.

Blood Pressure↗

Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women.

BACKGROUND: Few studies have reported the relationship between cardiorespiratory fitness and metabolic syndrome incidence, particularly in women. METHODS AND RESULTS: We prospectively studied 9007 men (mean+/-SD age, 44+/-9 years; body mass index, 25+/-3 kg/m2) and 1491 women (age, 44+/-9 years; body mass index, 22+/-2 kg/m2) who were free of metabolic syndrome and for whom measures of waist girth, resting blood pressure, fasting lipids, and glucose were taken during baseline and follow-up examinations. Baseline cardiorespiratory fitness was quantified as duration of a maximal treadmill test. Metabolic syndrome was defined with NCEP ATP-III criteria. During a mean follow-up of 5.7 years, 1346 men and 56 women developed metabolic syndrome. Age-adjusted incidence rates were significantly lower (linear trend, P<0.001) across incremental thirds of fitness in men and women. After further adjustment for potential confounders, multivariable hazard ratios for incident metabolic syndrome among men in the low, middle, and upper thirds of fitness, were 1.0 (referent), 0.74 (95% CI, 0.65 to 0.84), and 0.47 (95% CI, 0.40 to 0.54) (linear trend P<0.001); in women, they were 1.0 (referent), 0.80 (95% CI, 0.44 to 1.46), and 0.37 (95% CI, 0.18 to 0.80) (linear trend P=0.01), respectively. Similar patterns of significant inverse associations between fitness and metabolic syndrome incidence were seen when men were stratified on categories of body mass index, age, and number of baseline metabolic risk factors, but patterns were variable in women. CONCLUSIONS: Low cardiorespiratory fitness is a strong and independent predictor of incident metabolic syndrome in women and men. Clinicians should consider the potential benefits of greater cardiorespiratory fitness in the primary prevention of metabolic syndrome, particularly among patients who have already begun to cluster metabolic syndrome components.

Adult↗

Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density.

The relationship between physical fitness and bone mass in the femoral neck, lumbar spine, and forearm was studied in 84 normal women. Femoral neck and lumbar spine bone mineral density and forearm bone mineral content were estimated by absorptiometry. Fitness was quantitated from predicted maximal oxygen uptake. Femoral neck and lumbar bone mineral density were significantly correlated with fitness as well as age and weight. In the 46 postmenopausal subjects, fitness was the only significant predictor of femoral neck bone mineral density, and both weight and fitness predicted the lumbar bone mineral density. These data represent the first demonstration of a correlation between physical fitness, and, by implication, habitual physical activity, and bone mass in the femoral neck; they also support the previous reported correlation between lumbar bone mass and physical activity. The data suggest that increased physical fitness may increase bone mass at the sites of clinically important fractures in osteoporosis.

Adult↗

Cardiovascular fitness among U.S. adults: NHANES 1999-2000 and 2001-2002.

PURPOSE: To present information on cardiovascular fitness (estimated maximal oxygen uptake [VO2max] and cardiovascular fitness levels based on sex- and age-specific cut-points of estimated VO2max) among U.S. adults. METHODS: Analysis of data on 1978 adults (20-49 yr) who had completed a submaximal exercise test, from the National Health and Nutrition Examination Survey (1999-2000 and 2001-2002), a cross-sectional health survey of a nationally representative sample of the noninstitutionalized U.S. population RESULTS: Estimated VO2max was significantly lower (P < 0.01) in non-Hispanic black ([mean +/- standard error] 38.2 +/- 0.7 mL x min(-1) x kg(-1)) than Mexican-American and non-Hispanic white adults (41.5 +/- 0.6 and 40.6 +/- 0.4 mL x min(-1) x kg(-1), respectively). Estimated VO2max was also significantly lower (P < 0.001) in non-Hispanic black females (33.1 +/- 0.6 mL x min(-1) x kg(-1)) than in Mexican-American and non-Hispanic white females (37.0 +/- 0.7 and 36.4 +/- 0.4 mL x min(-1) x kg(-1), respectively). The proportion of low, moderate, and high cardiovascular fitness differed (P < 0.001) among race and race-sex groups. This difference was most striking among females, where 30.9% [95% confidence interval = 23.6-38.2%] of non-Hispanic black women had a low cardiovascular fitness level, compared with only 13.5% [10.0-17.0%] of non-Hispanic white and 18.9% [14.0-23.8%] of Mexican-American women. CONCLUSIONS: Adults of non-Hispanic black race have lower cardiovascular fitness than other major race groups in the United States. Nearly one third of non-Hispanic black women had a low cardiovascular fitness level, suggesting that this group in particular may be at increased health risk due to low cardiovascular fitness.

Adolescent↗

The influence of fitness and body weight on preferred exercise intensity.

PURPOSE: The purpose of this investigation was to determine the individual and combined effects of aerobic fitness and body weight on physiological responses, perceived exertion, and speed variables during self-selected steady-state treadmill (TM) walking in 60 healthy college-age women. METHODS: The women were placed into one of four categories based on body mass index (BMI) and fitness level, assessed by a graded TM test. Subjects walked continuously on a TM at a self-selected pace for 15 min at a 2.5% grade. The dependent variables were oxygen uptake (VO(2)), HR, percentage of maximal oxygen uptake (VO(2max)), percentage of HRmax (%HRmax), RPE for the overall body, TM belt speed, and total energy expenditure (EE). RESULTS: There were no significant interactions or body weight main effects for any of the dependent variables. However, lower-fitness subjects walked at a TM speed that resulted in a higher (P < 0.0005) VO(2max) (52.4 vs 39.56) than the higher-fitness subjects. CONCLUSION: These findings suggest that fitness, and not body weight, influences preferred exercise intensity as measured by VO(2max) during TM walking in college-age women. The self-selected walking speed did not result in an intensity, as determined by VO(2max), that is consistent with the enhancement of cardiorespiratory fitness for higher-fitness women regardless of body weight.

Adolescent↗

Autonomic recovery from peak arm exercise in fit and unfit individuals with paraplegia.

INTRODUCTION: Altered autonomic cardiovascular control in persons with paraplegia may reflect peripheral sympathetic denervation caused by the injury or deconditioning due to skeletal muscle paralysis. Parameters of autonomic cardiovascular control may be improved in fit persons with paraplegia similar to effects reported in the noninjured population. PURPOSE: To determine differences in resting and recovery HR and cardiac autonomic control in fit and unfit individuals with paraplegia. METHODS: Eighteen healthy males with paraplegia below T6 were studied; nine participated in aerobic exercise conditioning (fit: >or=30 min.d, >or=3 d.wk, >or=6 months), and nine were sedentary (unfit). Analysis of heart rate variability (HRV) was used to determine spectral power (ln transformed) in the high- (lnHF) and low-frequency (lnLF) bandwidths, and the LF/HF ratio was calculated. Data were collected at baseline (BL) and at 2, 10, 30, 60, and 90 min of recovery from peak arm cycle ergometry. RESULTS: The relative intensity achieved on the peak exercise test was comparable between the groups (i.e., 88% peak predicted HR). However, peak watts (P<0.001) and oxygen consumption (P<0.01) were higher in the fit compared with the unfit group (56 and 51%, respectively). Recovery lnHF was increased (P<0.05), and recovery lnLF (P<0.01) and LF/HF (P<0.05) were reduced in the fit compared with the unfit group. Mean recovery autonomic activity was not different from BL in the fit group. In the unfit group, mean recovery lnHF was reduced, and mean recovery lnLF and LF/HF remained elevated above BL. CONCLUSION: These data suggest that fit individuals with paraplegia have improved cardiac autonomic control during the postexercise recovery period compared with their unfit counterparts.

Adult↗