Daily steps threshold to improve cardiovascular disease risk factors during the year after an acute coronary syndrome.

PURPOSE: To evaluate the daily steps threshold associated with improved cardiovascular disease risk factors during the first year following an acute coronary syndrome. METHODS: Subjects (N = 41) were recruited during hospitalization for an acute coronary syndrome. A blinded pedometer with a 7-day memory (NL-2000) was used at baseline, 3, 6, 9, and 12 months following hospitalization. Cardiovascular disease risk factors were measured at baseline, 6, and 12 months after discharge. Subjects who maintained a mean of 7500 steps per day or more at each time period were classified into the active group, whereas those who did not maintain this threshold were classified into the less active group. RESULTS: The active group included 25 subjects, whereas 16 subjects were included in the less active group. Daily steps mean ± SEM was different between groups at 6 and 12 months followup (11 320 ± 3380 vs 5503 ± 1502 and 10 507 ± 2861 vs 6624 ± 3295 steps per day, respectively; both P < .001). Based on the analysis of variance for repeated measures (ANOVA-RM), the active group showed lower triglycerides (P < .01), lower waist circumference (P < .01), and higher high-density lipoprotein-cholesterol (HDL-C) (P = .04) at 12 months. Interaction effects (group × followup) were also significant for HDL-C (P = .01) and triglycerides (P = .01) after adjustment for age, gender, and baseline waist circumference. CONCLUSION: Targeting $7500 daily steps during 1 year may be efficient to maintain lowest waist circumference and to improve lipid profile during the year following an acute coronary syndrome. It could be considered a starting target point to initiate changes in physical activity behavior.

Assessment of management of cardiovascular risk factors in patients with thoracic aortic disease.

BACKGROUND: Cardiovascular risk profiles and adiposity assessment data in patients with thoracic aortic disease (TAD) are sparse. HYPOTHESIS: Despite the fact that TAD patients are considered as a high-risk population, they will not be managed as aggressively as they should in terms of their cardiovascular risk profile. MATERIALS AND METHODS: Anthropometric, blood pressure (BP) data, and blood samples were collected prospectively from patients followed at our TAD dedicated clinic. The same measures have been taken in a control group initiating a cardiac rehabilitation program. RESULTS: In all, 286 patients with TAD and 116 controls were recruited. BMI was higher among the controls than the patients with TAD (30.0±6.1 vs. 27.2±4.9 kg/m(2), respectively; P<0.001). We found no statistical difference between the groups for waist circumference (TAD: 93.1±15.2 and 103.6±14.5 cm, control: 95.0±13.4 and 106.3±14.8 cm, respectively, for women and men; P=0.06). In terms of lipid profile, low-density lipoprotein cholesterol was 2.44±0.88 in patients with TAD and 2.09±0.82 mmol/l in the controls (P<0.001). A higher percentage of patients with TAD had low-density lipoprotein cholesterol values that were beyond the target (63.3% in TAD vs. 46.1% in control; P<0.01). The values of apolipoprotein-B were similar between groups (P=0.41). BP was higher in patients with TAD (135±19/76±11 mmHg) versus the controls (129±17/71±11 mmHg; P<0.01). On the basis of ambulatory BP monitoring, 49.3% of patients with TAD were not well controlled for daytime and/or night-time BP. CONCLUSION: Cardiovascular risk factors, particularly BP, are not well controlled in patients with TAD followed in a dedicated clinic when compared with another high-risk control group in a cardiac rehabilitation program.

Safety and magnitude of changes in blood glucose levels following exercise performed in the fasted and the postprandial state in men with type 2 diabetes.

BACKGROUND: Information on the extent to which acute exercise reduces blood glucose levels (BGL) in type 2 diabetes is lacking. For this reason, the effects of exercise initiated at different preexercise BGL were assessed in men with type 2 diabetes both in the fasted (FS) and the postprandial states (PS). DESIGN AND METHODS: Forty-three men with type 2 diabetes, 12 on diet alone and 31 on hypoglycaemic agents, completed a total of 1555 exercise sessions performed in the FS and 0-1, 1-2, 2-3, 3-4, 4-5, and 5-8 h in the PS. Capillary BGL were measured before and immediately after a 1h standardized aerobic exercise session on an ergocycle at 60% of VO2 peak. RESULTS: In the FS, there was an increase in postexercise BGL of 27+/-21% (mean+/-SD; P<0.001) when preexercise BGL was < or =6 mmol/l, no change when preexercise BGL were between 6 and 8 mmol/l, and a significant decrease of 12+/-13% when preexercise BGL were >8 mmol/l (P<0.001). In the PS, most exercise sessions were associated with significant decreases in BGL ranging between 18+/-17 and 50+/-12% (P<0.001), depending on the time interval between meals and the onset of exercise. Regarding the metabolic PS, the decline in BGL was most pronounced with high preexercise BGL. CONCLUSIONS: Our observations not only demonstrate that it was safe for middle-aged obese men with type 2 diabetes to exercise in the FS, but also show that the decrease in BGL during aerobic exercise was largely dependent on preexercise BGL.