[The value of physical activity for prevention of coronary heart disease]

The usefulness of exercise as a preventive measure is discussed on the basis of a review of epidemiological studies. While no preventive effect has been reliably shown for physical activity at the workplace, physical exercise during leisure time does have such an effect. The incidence of myocardial infarction can be reduced by some 50 to 60%, although the contributions of protection and selection cannot be differentiated. The present data, however, militate against the possibility that, among those actively practicing sport, a primarily positive health selection effect is operative. The optimum of physical exercise would appear to be defined by a daily calorie consumption of 300 to 400 kcal (1250-1800 kJ) per day. Within the framework of secondary prevention, physical exercise can result in a reduction in mortality rate of 20%. The possibility of exercise related incidence prompts the requirement for a thorough physical check-up of those in the relevant risk groups.

[The dynamics of the parameters of central nervous activation as a correlate of the motor image]

EEG changes were studied in the case of real movements (wrestlers training) and also in the case of imagination of motor activity (ideomotor training). Statistically significant increases were found of the average frequency of oscillations in the EEG alpha-range and simultaneously typical vegetative changes. Thus, imagination of motor activity may serve as a model for studying the CNS activation processes in connection with the realization of real motor activity.

[Silent myocardial ischemia--risk for sports in coronary groups?]

The present discussion of SMI is of major impact on physical active coronary patients, since SMI during physical training could represent a potential risk factor. We carried out an investigation in 107 coronary patients of ambulant coronary groups (ACG) on the incidence of SMI during exercise testing and Holter monitoring (HM) including a training unit. With both techniques in approximately 1/3 of the patients SMI could be observed, when coronary medication was omitted. However the concordance of these two positive groups was found to be remarkably low. During HM SMI was found within the training units nearly as frequent as during normal daily life. By beta blockade (100 mg metoprolol) exercise SMI during HM was suppressed in 2/3. Our conclusion was that SMI is not of major significance in pharmacologically well controlled participants in ACG.

[Exercise hypertension--significance from the viewpoint of sports]

Exercise hypertension refers to an increase in blood pressure during dynamic exercise in excess of the limits in normotensive persons or those with borderline hypertension at rest as well as a disproportionately excessive increase in pressure in hypertensive persons in whom otherwise the increase in exercise pressure is shifted parallel to that of normotensive persons. There is no consensus for the absolute definition of exercise hypertension but traditionally, in sports medicine, systolic blood pressure values of 200 mmHg and more at a workload of 100 watts are considered abnormal. On the basis of the results of a study we performed in 2972 individuals, norms for exercise arterial blood pressure were constructed and found to be related to workload intensity as well as age. In contrast, there was no relationship between exercise blood pressure and exercise capacity or sex. In this regard, indirectly measured diastolic blood pressure is not reliably indicative of the actual prevailing pressure, particularly at higher workloads; it is, therefore, not considered to be useful in detection of exercise hypertension. In agreement with other studies, we found that up to one-third of all patients with normal blood pressure at rest but exercise hypertension eventually developed hypertension at rest. The incidence tended to increase with increasing age. Accordingly, exercise hypertension may be regarded as a precursor to established hypertension at rest.(ABSTRACT TRUNCATED AT 250 WORDS)

Physical exercise and antihypertensive drugs

Interactions and interrelations between antihypertensive drugs (AHD) and physical exercise are discussed on the basis of experimental results and of literature data. In physically active subjects AHD should lower the arterial pressure not only at rest, but also during physical stress. On the other hand, antihypertensive treatment should not influence physical performance. The main groups of AHD which could by applied in predominantly young and otherwise healthy subjects are: Beta-receptor blockers are recommended as first choice since they have a marked lowering effect on exercise blood pressure, conversely they impair by the same mechanism sympathetic stress adaptation. The effect of diuretics and calcium antagonists on exercise pressure is generally small; however, it may vary greatly in individual cases. As an interesting new category ACE-inhibitors should be studied further. Most AHD may impair the performance capacity of competitive athletes; however, sometimes they are also used illicitly to improve performance. In contrast, the symptom-limited performance of hypertensives is generally improved by therapy.

[Preventive cardiology: lack of exercise and physical training from the epidemiologic and experimental viewpoints]

A survey is given on epidemiological and experimental results of lack of exercise as a risk factor for coronary heart disease. The consequences of endurance training are described. It is evident that endurance sport or training during leisure time can have a greater effect than heavy muscular professional work. The selectively analysed factor "lack of exercise" may be less important as a risk factor than the protective influence of endurance training. Directions are given for carrying out a preventive program of training, with contraindications included.

[Effect of beta receptor blockaders on exercise induced extrasystoles]

The effect of a beta-receptor-blocking drug (200 mg Acebutolol pr os) on exercise-stimulated extrabeats (ES) by an ergometrical test was studied in 56 subjects. A reduction of the frequency of premature beats to minimally 50% was considered to be a positive result, which was found in 32 subjects. The best result could be observed in old people, in supraventricular and in the case of a fairly low number of ES. On the other hand the effect was smaller in young people, in ventricular and in frequent extra beats. In three cases polytopic extrasystoles and sinus arrhytmia appeared, which were not observed before. The results give some therapeutical hints. Further they stress the necessity to test the effect of an antiarrhythmical treatment in the individual case.

[The behavior of the physical performance capacity and the trainability of the cardio-pulmonary system in elder persons (author's transl)]

It is described the behaviour of the performance capacity of the cardio-pulmonary system during aging. The maximal O2-uptake declines beyond the third decade of life. The average mas has lost 1/3-1/4 of his earlier maximal performance capacity with the 60 year of life, the woman ca. 1/4-1/5. The causes are named. It follows a description of the work reaction of the cardio-pulmonary system during dosed ergometer strain. The influence of an endurance training on the untrained persons of the 7, decade of life is qualitative the same as in the young person. That applies in particularly for the aerobic capacity and the maximal stroke volume. Optimum kinds of sports are endurance sports with a low value of the quotient: (Formula; see text).