Occupational and leisure time physical activity and conventional risk factors were determined in the Belgian Physical Fitness Study, a prospective study of 2,363 healthy male factory workers who were aged 40-55 years at entry in 1976-1978 and who were followed for five years. Physical fitness, defined as the interpolated physical working capacity at heart rate 150 beats per minute, was measured in 2,109 subjects. In this subgroup, there were 31 myocardial infarctions and sudden deaths. Smoking, physical fitness, and high density lipoprotein cholesterol (HDL cholesterol) were independent risk indicators for subsequent ischemic heart disease, while both physical activity scores were not. It is concluded that in this healthy, predominantly sedentary population, the fitness level, but not the physical activity pattern, is an independent protective factor against ischemic heart disease.
Methods: This was a retrospective, time series analysis of 27 provider groups and managed care organizations from 1998 through 2006. Patients with hypertension were identified from more than 4000 physicians. Medical charts were collected and clinical data were evaluated using prevailing JNC criteria during the time period before and after JNC 7.Results: A total of 19,258 patients were identified with hypertension: 15,258 included in the before-JNC 7 cohort and 4,000 in the after-JNC 7 cohort. BP control in the before-JNC 7 cohort was 40.8% compared with 49.3% in the after-JNC 7 cohort (P < .0001). After controlling for demographic and clinical covariates, patients in the before-JNC 7 cohort were 45% less likely to achieve BP control compared with the after-JNC 7 cohort (odds ratio, 0.551; P < .0001).
Conclusion
Physical activity during leisure time and on the job have been measured with standardized interview techniques in 1,513 normal men, aged 40-55 years, who were regularly employed in different industries. Physical fitness was simultaneously estimated by measuring the work load at which a heart rate of 150 bpm was reached on a standardized exercise test. The median energy expenditure from leisure time activities above the basal metabolic rate was 195 kcal/day; 19% of these activities were classified as heavy, 37% as moderate and 43% as light intensity. The median energy expenditure from job physical activity was 1,676 kcal/day including basal metabolic rate. The median physical fitness level was 125 W. The leisure time activity score was significantly related to physical fitness through the light and the heavy intensity subscores. Independently, job physical activity was also significantly related to physical fitness. However, both activity scores accounted for only 2% of the variance in physical fitness. The data illustrate an overall low energy expenditure profile of middle-aged normal men and a low order relationship between physical activity pattern and physical fitness.
A prolonged supraselective intracoronary infusion of urokinase can be safely administered and may facilitate angioplasty of chronic total occlusions. Lower doses of urokinase are equally effective and result in fewer bleeding complications than do higher dosage regimens. Vessel patency is frequently maintained, but restenosis remains a problem.
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