and highest (64.0) among the least fit men, with the corresponding rates among the women 8.5 and 39.5 per 10,000 person-years, respectively. These findings closely parallel an earlier report among asymptomatic men from the Lipid Research Clinics (LRC) Mortality Follow-up Study,50 in which each 2-SD decrement in exercise capacity was associated with a two- to five-fold higher CHD or all-cause death rate. More recent studies, including one from the LRC,51 have reinforced the fact that these findings also apply to women who are healthy at the time of evaluation. Gulati et al.52 suggested that the strength of exercise capacity in predicting risk of mortality was even greater among women than men, reporting a 17% reduction in risk for every 1-MET increase in fitness. In the LRC, nearly 3,000 asymptomatic women underwent exercise testing and were followed for up to 20 years.51 A 20% decrease in survival was observed for every 1-MET decrement in exercise capacity. This study also pointed out the relative weakness of ischemic electrocardiogram (ECG) responses in predicting cardiovascular and all-cause mortality among women.
Table 37-1 ▪ RATES AND RELATIVE RISKS OF DEATH* AMONG HARVARD ALUMNI, BY PATTERNS OF PHYSICAL ACTIVITY
Table 37-2 ▪ RATES AND RELATIVE RISKS OF DEATH* AMONG 10,244 MEN AND 3,120 WOMEN, BY GRADIENTS OF PHYSICAL FITNESS
lack of physical activity,28 the nurse or other health care provider’s role is more critical than ever in terms of encouraging patients to become more physically active, and to develop strategies that promote the adoption of physically active lifestyles in all their patients.
Table 37-3 ▪ META-ANALYSIS OF CONTROLLED EXERCISE TRIALS IN PATIENTS WITH CHD
differences in general were not found in the rate of nonfatal recurrent reinfarctions in patients undergoing intervention compared with control patients.