Anna Jegier

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II)

In a previous paper, as the first of a series of three on the importance of characteristics and modalities of physical activity (PA) and exercise in the management of cardiovascular health within the general population, we concluded that, in the population at large, PA and aerobic exercise capacity clearly are inversely associated with increased cardiovascular disease risk and all-cause and cardiovascular mortality and that a dose–response curve on cardiovascular outcome has been demonstrated in most studies. More and more evidence is accumulated that engaging in regular PA and exercise interventions are essential components for reducing the severity of cardiovascular risk factors, such as obesity and abdominal fat, high BP, metabolic risk factors, and systemic inflammation. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit for each separate risk factor. The present paper, therefore, will review and make recommendations for PA and exercise training in the management of cardiovascular health in individuals with cardiovascular risk factors. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and individual members of the public. Based on previous and the current literature overviews, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and regarding appropriate risk evaluation during exercise in individuals with cardiovascular risk factors.

Employment Status and Self Rated Health

OBJECTIVES In many countries, reducing inequalities in health and mortality has become a significant problem. The aim of the study was to evaluate the association between employment status and self rated health in study population. MATERIAL AND METHODS The study was performed in the randomly selected population of individuals aged 25-64 years. Logistic regression was used to estimate odds ratios and 95% confidence intervals as well as to control the effects of employment status and self rated health. RESULTS The multifactorial logistic regression analysis indicates that, in men and women, self rated health was associated with employment status. Among unemployed men, the risk of low self health assessment was over 3 times higher than in the employed ones (adjusted OR = 3.34; 95% Cl: 1.96-11.58). Among unemployed women, the risk of low self health assessment was nearly 1.5 times higher than among the employed (adjusted OR = 1.35; 95% Cl: 1.06-3.02). CONCLUSIONS Self health assessment is related to a number of factors, including unemployment, low education or income, that increase the risk of poor health. These results emphasise the potential health consequences of unemployment and material circumstances in Poland.

Cardiovascular Risk Factors and Total Serum Antioxidant Capacity in Healthy Men and in Men with Coronary Heart Disease

Whether the incidence of coronary heart disease (CHD) is related to a decrease in total antioxidant capacity (TAC) has not yet been completely clarified. We assessed TAC of blood serum in a group of 163 men with CHD aged 34.8–77.0 years and in 163 age-matched peers without CHD. Two spectrophotometric methods were applied to assess TAC: ferric reducing ability of serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. In the CHD group, multivariate analysis revealed that uric acid (UA), triglycerides, and systolic blood pressure contributed independently to the TAC-FRAS variance. TAC-DPPH was favorably predicted by UA concentration, but negatively so by current smoking and glucose levels. In men without CHD, UA was the only independent determinant of both TAC-FRAS and TAC-DPPH. Presence of CHD was not an independent predictor of TAC—observed between-group differences (higher TAC in CHD patients) disappeared after adjustment for other confounders. We conclude that UA is the main determinant of TAC of blood serum in men. TAC is not directly influenced by age or CHD but is related to several indices of overweight/obesity and laboratory measures of metabolic syndrome, especially in patients with CHD.

Long-Term Effect of Different Physical Activity Levels on Subclinical Atherosclerosis in Middle-Aged Men: A 25-Year Prospective Study

Background The purpose of the study was to investigate the influence of lifetime physical activity (PA) on selected indices of atherosclerosis in longitudinal observation of middle-aged men. Methods The subject of the study was a cohort of 101 men (mean age 59,7±9,0 years), free of cardiovascular symptoms and treatment, participating in follow-up examinations in the years 1985/90-2011/12. Self-report PA was assessed by interviewer-administered Seven-Day PA Recall and Historical PA questionnaire. Subclinical atherosclerosis was measured by assessing the coronary artery calcification (CAC) according to Agatstons method using multi-slice computed tomography; the carotid intima-media thickness (IMT) using high-resolution B-mode ultrasound; and the reactive hyperemia index (RHI) using peripheral arterial tonometry (EndoPAT2000). The participants were initially divided into three groups according to tertiles of exercise-related energy expenditure (EE) in kcal/week at baseline, i.e. <2050 (low-to-moderate; n = 33), 2050–3840 (high; n = 34), >3840 (very high; n = 34). Results The low-to-moderate, high and very high PA groups were comparable in terms of age and atherosclerosis risk factors at baseline. No linear relationship was found between PA and CAC, IMT and RHI. Men who maintained low-to-moderate (n = 26), high (n = 21) and very high (n = 15) PA level had the mean CAC of 286.1±361.9, 10.7±28.9, and 106.1±278.3 (p<0.001 for low-to moderate vs high; p<0.05 for low-to-moderate vs very high); the mean IMT of 0.751±0.19 mm, 0,641±0.26 mm, and 0.750±0.60 mm (p>0.05); and the mean RHI of 1.69±0.4, 2.00±0.4, and 2.13±0.5 (p for trend = 0.050), respectively. No cases of CAC>400, IMT ≥0.9 and RHI<1.67 were noted only among men with maintained high PA level. At final examination men with high and very high PA had more favorable cardiometabolic profile than men with lower PA. Conclusions Maintaining regular high PA level through young and middle adulthood may protect against atherosclerosis as measured by CAC, IMT and RHI.

Alterations in Red Blood Cells and Plasma Properties after Acute Single Bout of Exercise

The aim of this study was to investigate alterations in haemoglobin conformation and parameters related to oxidative stress in whole erythrocytes, membranes, and plasma after a single bout of exercise in a group of young untrained men. Venous blood samples from eleven healthy young untrained males (age = 22 ± 2 years, BMI = 23 ± 2.5 kg/m2) were taken from the antecubital vein before an incremental cycling exercise test, immediately after exercise, and 1 hour after exercise. Individual heart rate response to this exercise was 195 ± 12 beats/min and the maximum wattage was 292 ± 27 W. Immediately after exercise, significant increase in standard parameters (haemoglobin, haematocrit, lactate levels, and plasma volume) of blood was observed as well as plasma antioxidant capacity one hour after exercise. Reversible conformational changes in haemoglobin, measured using a maleimide spin label, were found immediately following exercise. The concentration of ascorbic acid inside erythrocytes significantly decreased after exercise. A significant decline in membrane thiols was observed one hour after exercise, but simultaneously an increase in plasma thiols immediately after and 1 h after exercise was also observed. This study shows that a single bout of exercise can lead to mobilization of defensive antioxidant systems in blood against oxidative stress in young untrained men.

Physical activity and total antioxidant capacity across an adult lifespan of men.

PURPOSE The aim of the study was to determine the association between the long-term physical activity (PA) and the total antioxidant capacity (TAC) of blood serum and their association with coexisting risk factors of cardiometabolic diseases in a group of relatively healthy men. METHODS The research was conducted among 422 males age 19.2-89.8 yr, either sedentary or involved in recreational sports activities. Anthropometric measurements, lipid profile, and measurement of glucose and uric acid levels were performed in every man. Current PA, historical PA, and aerobic fitness (physical working capacity) were assessed. TAC was determined with two spectrophotometric methods: the ferric reducing ability of serum (TAC-FRAS) and 2,2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. RESULTS TAC was not related to the age of the subjects. Higher current and historical PA were associated with a more favorable cardiometabolic risk profile but not TAC. In fact, current PA level was connected with lower values of TAC-FRAS. Values of both TAC-FRAS and TAC-DPPH decreased with an increase of aerobic capacity. Individuals with coexisting anthropometric and biochemical risk factors of cardiovascular diseases and with elevated values of arterial pressure had higher TAC. Values of both TAC-FRAS (r = 0.66) and TAC-DPPH (r = 0.39) were strongly positively correlated with uric acid level. CONCLUSIONS Overweight, obesity, higher blood pressure, unfavorable blood lipid profile, and especially higher uric acid levels are connected with greater TAC of blood serum across an adult mans life. High PA and fitness are associated with a more favorable overall risk profile of cardiovascular and metabolic diseases but are related to lower TAC.

Investigation of oxidative stress parameters in different lifespan erythrocyte fractions in young untrained men after acute exercise

What is the central question of this study? What is the influence of a single bout of exercise on the properties of erythrocyte fractions at different ages? What is the main finding and its importance? A single bout of exercise in untrained men induced oxidative stress in erythrocytes and had an influence on antioxidant defense in these cells. Old erythrocytes were more sensitive to oxidative damage than young and middle‐aged cells. Higher levels of glutathione in old erythrocyte fractions did not protect them against oxidative stress. It seems that exercise may promote the removal of old erythrocytes from the circulation.

Blood Pressure Response to Submaximal Exercise Test in Adults

Background. The assessment of blood pressure (BP) response during exercise test is an important diagnostic instrument in cardiovascular system evaluation. The study aim was to determine normal values of BP response to submaximal, multistage exercise test in healthy adults with regard to their age, gender, and workload. Materials and Methods. The study was conducted in randomly selected normotensive subjects (n = 1015), 512 females and 498 males, aged 18–64 years (mean age 42.1 ± 12.7 years) divided into five age groups. All subjects were clinically healthy with no chronic diseases diagnosed. Exercise stress tests were performed using Monark bicycle ergometer until a minimum of 85% of physical capacity was reached. BP was measured at rest and at peak of each exercise test stage. Results. The relations between BP, age, and workload during exercise test were determined by linear regression analysis and can be illustrated by the equations: systolic BP (mmHg) = 0.346 × load (W) + 135.76 for males and systolic BP (mmHg) = 0.103 × load (W) + 155.72 for females. Conclusions. Systolic BP increases significantly and proportionally to workload increase during exercise test in healthy adults. The relation can be described by linear equation which can be useful in diagnostics of cardiovascular diseases.

Physical Activity, Aerobic Capacity, and Total Antioxidant Capacity in Healthy Men and in Men with Coronary Heart Disease

Objective. The purpose of the study was to assess total antioxidant capacity (TAC) of blood serum in relation with habitual leisure time physical activity (LTPA) and aerobic capacity in a group of 90 men with coronary heart disease (CHD) aged 34.8–77.0 years and in 90 age-matched peers without CHD. Methods. Two spectrophotometric methods were applied to assess TAC: Ferric Reducing Ability of Serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. Aerobic capacity was expressed as physical working capacity at 85% of the maximal heart rate (PWC85%HRmax). Results. CHD patients had higher values of TACFRAS (1.37 ± 0.28 versus 1.27 ± 0.23 mmol FeCl2·L−1; P < 0.05) but there were no group differences for TAC-DPPH and for uric acid (UA). Negative correlation was found between LTPA (also when calculated per kg of body mass) and TAC-DPPH in CHD patients. In CHD patients, TAC-FRAS and UA were lower in subjects with higher aerobic capacity expressed as PWC85%HRmax/kg. Those associations were not found in healthy men. Conclusions. We conclude that TAC of blood serum is moderately adversely related to LTPA and aerobic capacity in patients with CHD. UA, as the main determinant of serum TAC, may be partially responsible for those associations.

The effect of selected lifestyle factors and diet on mortality of men with documented physical fitness in the city of Łódź.

IntroductionIt is still uncertain if having at least moderate physical fitness is a necessary and sufficient condition for lowering the risk of death. The aforementioned statement constituted the basis for undertaking the study concerning the effect of particular health-related behaviours on the likelihood of survival in subjects with a moderate and high physical fitness.Materials and MethodsThe study sample, i.e. 204 men aged 30–59 years living in Łódź, Poland, was selected within the CINDI WHO Programme and examined over the years 1980–1990 and 2003–2004. In each subject approximate values of one week energy expenditures associated with performing physical exercise of at least moderate intensity (> 1000 kcal/week) were estimated. Physical efficiency in the study group was evaluated basing on the results of the submaximal effort test. Information about selected socio-demographic characteristics, consumption of alcohol, cigarette smoking and diet was gathered. The vital status of the examined sample was checked in 2009. The Cox proportional hazards regression model was used to identify factors which influence the survival of examined population.ResultsThe probability of death was more than fourfold higher in the case of individuals who eat “beef or pork meat”, as compared to those who consumed these products rarely or never. On the other hand, the subjects who declared regular consumption of yellow cheese had nearly fourfold lower death probability. Current smoking was found to be a significant negative risk factor while moderate consumption of beer a protective one. The level of physical fitness (VO2max) did not significantly influence mortality.ConclusionsThe results of the performed analyses indicate negative effect associated with consumption of beef/pork meat and smoking. Furthermore, the data pertaining to the consumption of yellow cheese as a potent protective factor for men’s health requires further verification. The possibility that it is some lifestyle proxy rather than a causal factor cannot be excluded.