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Chronic aerobic exercise lowers blood pressure (BP), peripheral resistance and cardiac work, and is used widely in antihypertensive and cardiac rehabilitation programmes. In this study, we tested the hypothesis that the cardiovascular benefits of training would occur progressively over several weeks and would diminish over a similar time course on termination of training. In all, 17 young, healthy men undertook a 4-week programme of cycle ergometry (30 min at 60% VO 2peak 3-4 times/week) and 13 subjects matched for age, body mass index and fitness acted as controls. Resting BP and rate-pressure product (RPP) had fallen significantly after only 1 week's training and reached a nadir after 2 weeks training. At this time, BP had fallen from 12177/ 6676 to 11075/5777 mmHg and resting RPP had fallen from 85710 to 7179 (mmHg (beats min À1 )) À2 (Po0.001 each). In parallel, resting forearm conductance had risen from 0.02670.010 to 0.05270.029 (ml min À1 ) 100 ml À1 mmHg À1 and peak reactive hyperaemia following 3 min brachial artery occlusion was increased from 0.10570.031 to 0.20970.041 (ml min À1 ) 100 ml À1 mmHg À1 (Po0.001 each). No significant further circulatory changes occurred over weeks 3-4 of training. On cessation of training, all values returned to pretraining levels within between 1 (SBP, RPP, vascular conductance) and 2 (DBP, MAP, heart rate, reactive hyperaemia) weeks. The results indicate that the optimal cardiovascular benefits of moderate exercise occur rapidly. At least with short training programmes, the benefits regress once training stops just as quickly as they appeared.

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In the past two decades much has changed in the way of employee assistance programs. However, substance abuse among workers and its interference with job performance has not changed. While some have argued that greater emphasis be placed on preventative measures, the author believes that from the inception, employee assistance programs have been preventative—by educating the public, by performing screening and gatekeeping functions for referrals, and by providing feedback from providers on how employees are progressing.

No abstract