SUMMARY We examined associations between physical fitness and risk factors for coronary heart disease in healthy women ages 18-65 years. Physical fitness was objectively determined by the duration of a maximal treadmill exercise test. Six physical fitness categories (very poor to superior), specific within 10-year age increments, were established. Mean risk factor levels varied across categories, but so did potential confounders such as age and weight. Multiple linear regression modeling was used to control for the effects of age, weight and year of exam on coronary risk factors. After adjustment, physical fitness was independently associated with triglycerides (p < 0.001), high-density lipoprotein cholesterol (HDL-C) (p -0.001), total cholesterol/HDL-C ratio (p S 0.001), blood pressure (p si 0.001) and cigarette smoking (p -0.001).IT IS WELL ESTABLISHED that men have a higher incidence of cardiovascular disease than women. Nonetheless, coronary heart disease (CHD) is the leading cause of death in women (259 deaths/100,000 per year), with women in the United States having high rates compared with the rest of the world.' These statistics belie the relative paucity of research in CHD epidemiology in women. Available data, notably from the Framingham study, support the classic risk factor hypothesis for CHD in women. Women with higher levels of blood cholesterol, high blood pressure, and who smoke cigarettes are more likely to develop CHD than women without these risk factors. aware of any such studies in women. Although the precise role of physical activity in the prevention of CHD is not known, a tenable hypothesis is that more active persons have lower levels of established -risk factors. We previously showed that men who were more physically fit had lower levels of CHD risk than their less physically fit peers.6The purpose of this paper is to examine the association between physical fitness and CHD risk factors in women. We hypothesized that women with higher levels of physical fitness have a lower CHD risk. MethodsMore than 3900 adult women, ages 18-65 years, were examined from 1971 to 1980. Some women received only a treadmill test, but 2854 received a complete physical examination, including CHD risk factor measurements. Most of these women were self-referred for the purpose of physical fitness evaluation, periodic health examination or receiving preventive medical advice. These patients tended to be well educated and from middle to upper socioeconomic strata. More than 99% of the women were white. Data reported in this paper are from the first clinic visit for these

A random sample of 117 teachers in three treatment schools and one control school participated in a health survey at the beginning and end of the spring semester. Teachers in the treatment schools participated in a 10-week health promotion program which emphasized exercise, stress management, and nutrition. Comparison of pre-and post-survey data indicated that teachers in the treatment schools increased their participation in vigorous exercise, improved their physical fitness, lost weight, lowered their blood pressure, reported a higher level of general well-being, and were better able to handle job stress. (Am J Public Health 1984; 74:147-149.) Employee health promotion programs have become increasingly popular over the last decade,' but their evaluation has been inadequate.23 In this paper we present the results of a comprehensive evaluation of program effects in a health promotion program for educators. Materials and MethodsWe used a quasi-experimental design4-5 with three treatment schools and one control school selected by the administration of the school district which wanted to offer the program to all three school levels and to schools in different neighborhoods.* There was no prior consultation with the individual schools nor was there any attempt to ascertain whether any school was especially interested in health promotion. Measurements were obtained before and after a 10-week health promotion program. A second control school (elementary-middle class White neighborhood, predominately White faculty) was selected for an after-only study.More than 90 per cent of all faculties volunteered. Program participants were randomly selected from the list of volunteers: 87 in the treatment schools and 30 in the control school.** The average age was 38 ± 9.1 years; 73 per cent were women; 62 per cent were White; 26 per cent were Black; and 12 per cent were Hispanic. Of the 117 participants, 113 participated in the baseline and follow-up surveys. Due to missing data for some variables, the number of cases for each analysis may be somewhat less than the 113.Health knowledge was measured by a 30-item multiple choice test which covered a variety of physical fitness and health promotion concepts. Exercise participation was assessed with a self-administered seven-day physical activity *Characteristics of the three treatment schools were: I) elementaryHispanic neighborhood, primarily Hispanic faculty; 2) middle-predominantly Black neighborhood, primarily Black faculty; and 3) high school-affluent White neighborhood, primarily White faculty. The control school was a middle school in a mixed Black and White neighborhood with a mixed Black and White faculty. **The number of participants in each school was based on logistics. We believed that 30/school was the maximum number that could be accommodated in the intervention program due to staff constraints.

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Summary The relationship between extramarital affairs and cardiovascular risk is still not completely clarified. The aim of this study was to investigate whether extramarital affairs have a protective effect on cardiovascular risk or, conversely, a deleterious one. Among patients studied, 91.8% of the whole sample reported no or occasional extramarital affairs, while 8.2% declared a stable secondary relationship. During a median follow‐up of 4 [0–8] years, 95 major adverse cardiovascular events (MACE), eight of which were fatal, were observed. Cox analysis, after adjustment for confounding factors, showed that presence of stable extramarital affair was associated with a higher incidence of MACE (HR = 2.13 [1.12; 4.07], p = 0.023). The introduction in the Cox model of patient perceived partner’s hypoactive sexual desire (PPPHSD) attenuates the association (HR 1.86 [0.93; 3.70], p = 0.078). The sample was therefore divided according to PPPHSD. We observed that unadjusted incidence of MACE was significantly associated with presence of extramarital affairs only in men reporting a primal partner without PPPHSD. This association was also confirmed in a Cox regression model, after adjusting for confounders (HR = 2.87 [1.81; 6.98], p = 0.020). We can conclude that to be unfaithful represents an independent risk factor for MACE. Therefore, infidelity induces not only heart trouble in the betrayed partners, but seems to be also able to increase the betrayer’s heart‐related events.