摘要:

Patients who are involved with exercise, dynamic or static, may have blunted or abnormal physiologic or biochemical responses as a result of multiple drug regimens. The present review attempts to highlight the quickly developing field of drug-exercise interactions involving medications taken by patients with cardiovascular disease. Except for the whole class of beta-blocking drugs, which can blunt performance, most of the drugs used in cardiovascular medicine and/or rehabilitation generally allow for a normal or nearly normal exercise response.

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The purpose of this project was to test the efficacy of diet and daily walking for treating mild to moderate hypertension. In phase I, a total of 268 confirmed hypertensive patients (161 men and 107 women aged 38 to 67 years) were treated with a high-complex-carbohydrate, high-fiber, low-fat, and low-salt diet combined with daily walking (1 hr) for 26 days. Of the 216 patients who entered the program receiving antihypertensive medication for at least one year, 180 left the program off medication and with a significant reduction in blood pressure (BP) (134 ± 2/77 ± 1 to 130 ± 2/73 ± 1 mm Hg). Of the remaining 36 patients (17%), many had their antihypertensive medication reduced; however, for this group there was no significant change in BP (151 ± 3/77 ± 2 versus 149 ± 4/77 ± 2 mm Hg). In the 50 patients who were not taking antihypertensive medication when they entered the program, BP was reduced from 152 ± 2/84 ± 1 to 138 ± 2/75 ± 1 mm Hg. Correlations between change in blood pressure and change in weight, cholesterol, or triglycerides were all low (r ≤ .27).In a second study, 13 patients were placed on the diet for six weeks without any exercise. During the first four weeks, BP was reduced from 137 ± 4/82 ± 3 to 123 ± 3/73 ± 2 mm Hg, and six of 12 patients were taken off antihypertensive medication. During the fifth and sixth weeks, NaCl intake was increased by 5 g/day, and BP increased to 132 ± 4/77 ± 2 mm Hg, due mainly to major increases in BP in three “salt-sensitive” patients.These data show that appropriate diet modification and excercise can be an effective nonpharmacologic means of lowering blood pressure in a majority of patients with mild hypertension and in some with more severe hypertension.

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

In a previous report we presented a stress test index of myocardial efficiency (MEI) that correlates the maximal work load achieved with oxygen uptake (represented by the double product [DP]) and body surface area. As no correlation between the MEI and angiographic ejection fraction (EF) at rest could be demonstrated, we investigated the relationship between the MEI and radionuclide EF determined during exercise. The ejection fractions of 57 patients (46 men and 11 women) were measured by blood-pool equilibrium gated radionuclide angiography at rest and during maximal exercise, and the results were compared with the MEI. The patients were divided as follows: group 1 (N = 19) was composed of subjects without coronary disease; group 2 (N = 12), patients with coronary artery disease but with a normal resting and exercise EF; group 3 (N = 14), coronary patients with a normal EF at rest decreasing with stress; and group 4 (N = 12), coronary patients with an EF diminished at rest and even more so during exercise. The MEI was normal for group 1, slightly diminished for group 2 (the difference was not significant), and clearly diminished for groups 3 and 4 (P < .025 and P < .005, respectively, as compared with group 1). There were no significant differences in MEI between patients with normal and patients with diminished resting EF; on the contrary, a highly significant difference was obtained when patients with a normal increase of the exercise EF were compared with those with aflat or depressed response to stress (1.38 ± 0.27 versus 1.12 ± 0.30, P < .0025). We conclude that the MEI has a significant correlation with the radionuclide EF during exercise independent of its basal values, although there is a tendency towards lower indices in patients with decreased basal EF.

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Since 1972, there has been a gradual decline in the age-adjusted death rate (AADR)/1,000 people due to myocardial infarction (MI) in Nebraska (1,671 to 1,165, −30%), despite a 5.8% increase in population. Prehospital AADR due to MI dropped from 0.809 to 0.459 (-43%), although AADR due to non-MI heart disease fell only 4.6% (1.438 to 1.371). These changes coincided with an intensive statewide effort to improve emergency cardiac care (ECC), which includes professional and public education, prehospital delivery system, emergency department, and treatment in the intensive care unit. The number of Nebraskans trained in cardiopulmonary resuscitation (CPR) was chosen as an index of overall ECC activity and the number of emergency medical technicians (EMTs) was used as an index of prehospital system development. By 1980, over 300,000 Nebraskans were trained in CPR. The total number trained correlates with the decline in AADR due to MI (r = .80) and prehospital MI (r = .78). Although EMTs account for only 6.5% of all Nebraskans trained in CPR, their increase correlates highly with the decline in prehospital AADR due to MI (r = .98) but not with non-MI heart disease. We conclude that ECC may be contributing to the overall decline in deaths due to MI and that prehospital components of ECC are responsible for the 43% decrease in prehospital MI deaths in Nebraska over the last ten years.

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

QUESTIONS AND ANSWERS is a regular feature in which leading clinicians and researchers share with their colleagues their views on matters that are relevant to cardiac rehabilitation. The coeditors invite Journal of Cardiac Rehabilitation readers to suggest questions for discussion in this forum.

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1983

数据来源: OVID