Oxygen uptake and its relation to physical activity and other coronary risk factors in asymptomatic middle-aged Japanese.

PURPOSE: Low physical activity is considered to be an important risk factor for atherosclerotic coronary artery disease. However, few data are reported on the Japanese general population. The authors have studied whether oxygen uptake in physical fitness evaluation is a quantitative index for physical activity and whether or not it has a relation to coronary risk factors. METHODS: Five hundred thirteen asymptomatic Japanese (40-64 years of age, 282 males and 231 females) were tested on a cycle ergometer for measurement of peak oxygen uptake (peak VO2) and oxygen uptake at anaerobic threshold (VO2AT). Physical activity was estimated by pedometer score. Data for oxygen uptake were adjusted by age or by age and body mass index (BMI), then its relationship to the following risk factors was investigated: physical activity, BMI, blood pressure, total cholesterol, HDL and LDL cholesterol, fasting blood glucose, and triglycerides. RESULTS: Subjects in the highest peak VO2 quartile walked significantly more than those in the lowest quartile in both males and females. Those in the highest quartile showed lower BMI, lower blood pressure, lower triglyceride, and higher HDL cholesterol. The same relationship was observed for VO2AT. CONCLUSIONS: Higher fitness level determined by peak VO2 or VO2AT is related to higher physical activity and lower coronary risk factors in the asymptomatic middle-aged Japanese. These data provide support for exercise prescription in the primary prevention of coronary heart disease in Japan.

[Effect of body weight reduction on blood pressure and biochemical data].

The purpose of this study was to investigate the relation between body weight reduction and some complications associated with obesity. The subjects were 248 middle-aged obese persons (male 37, female 209) who participated in a weight reduction program at the Aichi Prefectural Center of Health Care from 1983 to 1990. The subjects had no severe complication, and the obesity indexes of all of them were over 120%. The program was held monthly for five months and consisted of diet (1500 kcal/day) and exercise (10000 walk steps/day). After the program, mean obesity index decreased by about 9%, and mean body weight reduction was about 5kg. Blood pressure, total cholesterol, triglyceride and GPT were significantly decreased, and HDL cholesterol was slightly increased. For each item the percentage of persons with abnormal values reduced by about 5 to 20%. From the relationship between degree of decrease of obesity and changes of the values of each item, it was estimated that some complications of obesity require greater than 5 to 10% decrease in obesity index to be affected. The value of each examination item before the program and the degree of decrease of obesity index had an effect on changes of the values, but obesity index before the program and age had little effect.

Criteria for screening diabetes mellitus using serum fructosamine level and fasting plasma glucose level. The Japanese Society of Multiphasic Health Testing and Services (JMHT), Fructosamine Working Committee.

A screening method using serum fructosamine level and the fasting plasma glucose level was used for screening patients with diabetes mellitus. The criteria for positive tests recommended by the Japanese Society of Multiphasic Health Testing and Services were evaluated. It was found that levels for the serum fructosamine of 290 mumol/l or higher (or, for the fasting plasma glucose of 110 mg/dl or higher) agreed with the standard oral glucose tolerance test in identifying patients with diabetes mellitus in 96.7% of cases, and the serum fructosamine test was simpler and less expensive.

[Effect of daily energy intake and amount of walking on body weight reduction and its maintenance].

The relationship of daily energy intake and the amount of walking performed, based on pedometer readings, for effective body weight reduction were studied based on results of a weight reduction program at the Aichi Prefectural Center of Health Care from 1983 to 1990. In addition, a follow-up study based on a mailed questionnaire was performed, to further determine the relationship to maintenance of body weight reduction of energy intake and amount of walking after the conclusion of program. The subjects were two-hundred and forty middle-aged obese women who were placed on a 5-month weight reduction program consisting of diet (1500 kcal/day) and exercise (10000 walk steps/day). At the end of the program, the mean energy intake and the mean number of steps per day had reached target levels and the mean body weight reduction was 4.2 kg. The relationship of energy intake, and the number of steps walked at the end of program to the amount of reduction in body weight during the program was analyzed by multiple regression analysis, and the amount of walking expressed in the number of steps necessary for weight reduction were calculated for various energy intakes. A follow-up study was performed in 1988, with sixty-six women responding to the mailed questionnaire. Since the end of the program, body weight increase of 1.1 kg occurred, but body weight was still lower than initially. Although mean energy intake increased after the program, a level about 200 kcal less than at the beginning of the program was being maintained, so the effect of diet recommendation in the program appeared to be retained.(ABSTRACT TRUNCATED AT 250 WORDS)

[Relation of baseline examination results to death from ischemic heart disease, cerebro-vascular disease and sudden death].

The relation of variables obtained from a baseline examination to death from ischemic heart disease (IHD), cerebro-vascular disease (CVD) and sudden death (SUD) was analyzed in a case-control study. From questionnaire survey of approximately 180,000 subjects who underwent baseline health examinations in 1971-1986 at Aichi prefectural center of health care, 148 deaths were selected for this study. The number of cases on IHD, CVD and SUD was 36, 60, and 52, respectively. Mean age of cases was 54.8 years old and the mean follow up interval between baseline examination and death was 3.7 years. Four controls matched according to year of baseline examination, age and sex were chosen arbitrarily for each case, and odds ratios for the three diseases were estimated. In some of the matched sets, odds ratios at a follow up examination were compared with that at the first examination. The results were as follows: 1) Variables showing positive relationships to death from each of the three diseases were hypertension, high fasting blood sugar, abnormality of cardio-thoracic ratio, ST-T abnormality in ECG, left ventricular hypertrophy in ECG. The odds ratio for ST-T abnormality in ECG was significant for all three causes of death. 2) High total cholesterol showed a significant positive relation only to death from IHD. As to death from CVD and SUD, albuminuria and sclerotic changes in fundus oculi were positively and significantly related. Risk factors differed for deaths from the three diseases. 3) In death from IHD and CVD, odds ratio at the second examination was apt to be higher than that at baseline examination. In death from SUD, however, odds ratios at the first and the second examination showed no significant difference.

Effects of exercise on coronary risk factors in obese, middle-aged subjects.

The effects of exercise (10000 walk steps/day) and diet (1500 kcal/day) for 4 months on coronary risk factors (obesity, hypertension, serum lipid and lipoprotein abnormalities) were studied in 332 obese, middle-aged subjects. Body weight, skinfold thickness, systolic and diastolic blood pressures, serum lipid and lipoproteins (total cholesterol, triglyceride, and beta-lipoprotein) improved significantly (p less than 0.05) during the program. The degree of improvement in blood pressures, serum lipids and lipoproteins was greater in abnormal blood pressure (greater than 140/90 mmHg) or abnormal serum lipid group than in normal group. A significant correlation was observed between daily number of walk steps and the improvement of body weight, diastolic blood pressure and HDL-cholesterol. Increase of daily steps during the program showed a significant (p less than 0.05) correlation to the change in HDL-cholesterol. It was suggested that mild exercise characterized by brisk walking was effective in the treatment of obesity, hypertension and low HDL-cholesterolemia in obese, middle-aged subjects.

Methodology of ECG interpretation in the Nagoya program.

The outline of the Nagoya Program, the most representative software package for computerized electrocardiography in Japan, is described. First, the history and current status of research and its transfer to commercial products for computerized interpretation of electrocardiograms is briefly reviewed. Second, development and testing of the Nagoya Program is depicted, referring to a gold standard for evaluation and the database being used for this purpose, and to its participation in the CSE study. Third, a description of signal acquisition and wave identification is given, followed by the detection of rhythm disturbances. Next, algorithms for contour classification, which consist of decision-tree logic established through trial and error and making use of the database of ECGs, are described. Finally, special features and future plans of the Nagoya Program are mentioned.

Clinical evaluation on 5 years' experience of automated phonocardiographic analysis.

A mini-computer system for PCG interpretation has been functioning since 1971. The system can analyze as many as 100 PCG's in 3 hours. Based on our 5 years' experience, computer interpretation of PCG's has proved itself valuable for the rapid mass-screening of cardiovascular disease. It also provides more objective and quantitative information than human auscultation, though it is still at a developmental stage because of the present technical limitations. The solution of these shortcomings should achieve an automated PCG analysis of high accuracy.