Contrary to earlier smaller trials, we observed similar improvements in exercise capacity and peripheral endothelial function following AIT and ACT in a large population of CAD patients.

Abstract-We reviewed the effect of resistance training on blood pressure and other cardiovascular risk factors in adults.Randomized, controlled trials lasting Ն4 weeks investigating the effects of resistance training on blood pressure in healthy adults (age Ն18 years) and published in a peer-reviewed journal up to June 2010 were included. Random-and fixed-effects models were used for analyses, with data reported as weighted means and 95% confidence limits. We included 28 randomized, controlled trials, involving 33 study groups and 1012 participants. Overall, resistance training induced a significant blood pressure reduction in 28 normotensive or prehypertensive study groups [Ϫ3.9 (Ϫ6.4; Ϫ1.2)/Ϫ3. H igh blood pressure (BP) is 1 of the 9 leading risk factors influencing the global burden of cardiovascular disease 1 and is estimated to lead to Ͼ7 million deaths each year, that is, about 13% of the total deaths worldwide. 2 Data from observational studies in healthy individuals show a direct, strong, independent, and continuous relation between BP and cardiovascular morbidity and mortality without any evidence of a threshold down to at least 115/75 mm Hg. 3 Therefore, adequate control of BP is important for public health. Lowering of BP and prevention of hypertension is in first instance preferable by lifestyle changes. These include weight loss, moderation of alcohol intake, a diet with increased fresh fruit and vegetables, reduced saturated fat, reduced salt intake, and, finally, increased physical activity. 2,4 With regard to the latter, former guidelines predominantly recommended aerobic exercises such as walking, jogging, and cycling for lowering BP. Nowadays, aside from the well-documented effects of resistance training (RT) for the maintenance of functional capacity and prevention of sarcopenia and osteoporosis, a body of research is emerging that shows that RT may also beneficially affect metabolic health. 5 This information may be important because it effectively highlights an underappreciated aspect of RT. Therefore, both the American Heart Association and the American College of Sports Medicine have endorsed the inclusion of RT as an integral part of an exercise program for promoting health and preventing cardiovascular disease. 5,6 However, contrary to endurance training, evidence for a BP-lowering effect of RT remains scarce and much less compelling. Whereas the most recent meta-analysis on the effect of RT, published in 2005, already suggested that moderate RT could become part of the nonpharmacological intervention strategy to prevent and decrease high BP, this conclusion was based on only 9 randomized, controlled trials, involving 12 study groups. 7 Further, these trials have generally been small and often of questionable methodological quality. Since then, the number

In CAD patients with preserved and/or reduced LVEF, AIT is superior to MCT for improving peakVO2, while MCT seems to be more effective in reducing body weight. However, large, well-designed, randomized controlled trials are warranted to confirm these findings.

ObjectivesTo describe healthcare providers’ symptoms evoked by patient safety incidents (PSIs), the duration of these symptoms and the association with the degree of patient harm caused by the incident.DesignCross-sectional survey.Setting32 Dutch hospitals that participate in the ‘Peer Support Collaborative’.Participants4369 healthcare providers (1619 doctors and 2750 nurses) involved in a PSI at any time during their career.InterventionsAll doctors and nurses working in direct patient care in the 32 participating hospitals were invited via email to participate in an online survey.Primary and secondary outcome measuresPrevalence of symptoms, symptom duration and its relationship with the degree of patient harm.ResultsIn total 4369 respondents were involved in a PSI and completely filled in the questionnaire. Of these, 462 reported having been involved in a PSI with permanent harm or death during the last 6 months. This had a personal, professional impact as well as impact on effective teamwork requirements. The impact of a PSI increased when the degree of patient harm was more severe. The most common symptom was hypervigilance (53.0%). The three most common symptoms related to teamwork were having doubts about knowledge and skill (27.0%), feeling unable to provide quality care (15.6%) and feeling uncomfortable within the team (15.5%). PSI with permanent harm or death was related to eightfold higher likelihood of provider-related symptoms lasting for more than 1 month and ninefold lasting longer than 6 months compared with symptoms reported when the PSI caused no harm.ConclusionThe impact of PSI remains an underestimated problem. The higher the degree of harm, the longer the symptoms last. Future studies should evaluate how these data can be integrated in evidence-based support systems.

The short-term improvements of center-based AIT and ACT on physical fitness, physical activity, peripheral endothelial function, cardiovascular risk factors and QoL are sustained after a 1-year follow-up period. The majority of patients (>90%) met the recommended physical activity levels of 150 minutes/week.