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Biomedical subjects

L W Gibbons

Publications and source records attributed to L W Gibbons.

14 recordsLinked to original sources
PubMed1995

Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men.

OBJECTIVE: To evaluate the relationship between changes in physical fitness and risk of mortality in men. DESIGN: Prospective study, with two clinical examinations (mean interval between examinations, 4.9 years) to assess change or lack of change in physical fitness as associated with risk of mortality during follow-up after the subsequent examination (mean follow-up from subsequent examination, 5.1 years). SETTING: Preventive medicine clinic. STUDY PARTICIPANTS: Participants were 9777 men given two preventive medical examinations, each of which included assessment of physical fitness by maximal exercise tests and evaluation of health status. MAIN OUTCOME MEASURES: All cause (n = 223) and cardiovascular disease (n = 87) mortality. RESULTS: The highest age-adjusted all-cause death rate was observed in men who were unfit at both examinations (122.0/10,000 man-years); the lowest death rate was in men who were physically fit at both examinations (39.6/10,000 man-years). Men who improved from unfit to fit between the first and subsequent examinations had an age-adjusted death rate of 67.7/10,000 man-years. This is a reduction in mortality risk of 44% (95% confidence interval, 25% to 59%) relative to men who remained unfit at both examinations. Improvement in fitness was associated with lower death rates after adjusting for age, health status, and other risk factors of premature mortality. For each minute increase in maximal treadmill time between examinations, there was a corresponding 7.9% (P = .001) decrease in risk of mortality. Similar results were seen when the group was stratified by health status, and for cardiovascular disease mortality. CONCLUSIONS: Men who maintained or improved adequate physical fitness were less likely to die from all causes and from cardiovascular disease during follow-up than persistently unfit men. Physicians should encourage unfit men to improve their fitness by starting a physical activity program.

Adult↗
PubMed1995

The prevalence of side effects with regular and sustained-release nicotinic acid.

PURPOSE: To document the prevalence and nature of the side effects that occur with the use of regular and sustained-release nicotinic acid in everyday clinical practice. PATIENTS AND METHODS: One hundred and ten patients seen in a private medical clinic who were given 133 separate trials of nicotinic acid during a 5-year period. The occurrence of side effects, particularly those severe enough to warrant discontinuing the drug, were carefully monitored. RESULTS: Forty-three percent of individuals given regular nicotinic acid and 42% of those given sustained-release nicotinic acid were forced to discontinue the medication because of side effects; some of these side effects necessitating discontinuing nicotinic acid did not occur until the patient had been taking the drug for 1 or 2 years. CONCLUSION: Nicotinic acid in both regular and sustained-release forms is a powerful drug when used in doses needed to treat lipid disorders and causes disturbing side effects a very high percentage of the time. No one should use nicotinic acid in these doses without continued careful supervision of a physician.

Adult↗
PubMed1991

Physical fitness and all-cause mortality in hypertensive men.

All-cause death rates in normotensive and hypertensive men were examined across physical fitness levels. Subjects were 10,224 healthy normotensive men and 1,832 men who reported a history of hypertension, but were otherwise healthy. Physical fitness was determined by maximal treadmill exercise testing. Baseline preventive medical examinations were given during 1970-1981, and mortality surveillance was conducted on the cohort through 1985. There were 240 deaths in the normotensive men and 78 deaths in hypertensive men. Age-adjusted all-cause mortality rates per 10,000 man-years of follow-up in normotensive men ranged from 64.0 in the least fit quintile to 18.6 in the most fit quintile. Corresponding rates for hypertensive men were 110.5 to 24.8. Subjects were further classified into lower and higher blood pressure groups by baseline resting systolic blood pressure (less than 140 mmHg and greater than or equal to 140 mmHg). Normotensive and hypertensive men who were more fit had lower death rates compared to less fit men within both of the measured blood pressure strata. The relation between fitness and all-cause mortality held in multiple logistic regression analyses after adjustment for the influence of age, serum cholesterol, resting systolic blood pressure, body mass index, current smoking habit, and length of follow-up. We conclude that low levels of physical fitness result in an increased risk for all-cause mortality in normotensive and hypertensive men.

Adult↗
PubMed1990

An empirical evaluation of the ACSM guidelines for exercise testing.

The American College of Sports Medicine (ACSM) has published exercise guidelines identifying individuals who should have an exercise test prior to clearance for exercise participation and whether a physician should supervise the test. These age and health status criteria (apparently healthy, higher risk, and diseased) were developed using clinical judgement and opinion rather than empirical data. Thus, there is a need to validate the recommendations with actual data. We studied the results of 24,332 maximal treadmill tests in men (n = 18,076) and women (n = 5,626) as they associated with age and baseline health status. Commonly accepted criteria for abnormal exercise tests were used (i.e., 1 mm ST segment depression at 0.08 s, systolic blood pressure drop with exercise, complex ventricular ectopy, etc.). There were 895 and 183 abnormal exercise tests in men and women, respectively. Men and women who were apparently healthy had lower abnormality rates per 1,000 tests than those considered to be at higher risk for coronary heart disease and those who had preexisting disease. Further, when those who were at higher risk were considered, those men with only one risk factor had significantly lower abnormality rates than did men with more than one risk factor (95% confidence intervals (CI) per 1,000 tests: 1 risk factor = 36.1-46.4; greater than 1 risk factor = 47.5-62.5). Abnormality rates in women with 1 risk factor were also lower than those in their peers with greater than 1 risk factor, but not statistically so (95% CI per 1,000 tests: 1 risk factor = 24.9-43.0; greater than 1 risk factor = 25.3-54.4).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Physical fitness and all-cause mortality. A prospective study of healthy men and women.

We studied physical fitness and risk of all-cause and cause-specific mortality in 10,224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110,482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (slope, -4.5). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years (slope, -5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.

Adult↗
PubMed1989

Corporate fitness programmes and health enhancement.

The corporate environment is a convenient and practical place to promote exercise and fitness. There is now evidence that corporate sponsored fitness programs will decrease employee turnover, decrease absenteeism, decrease industrial injuries, decrease corporate medical costs, and increase productivity, in addition to the personal benefits gained by the participants.

Absenteeism↗
PubMed1984

Physical fitness and incidence of hypertension in healthy normotensive men and women.

We measured physical fitness, assessed by maximal treadmill testing in 4,820 men and 1,219 women aged 20 to 65 years. Participants had no history of cardiovascular disease and were normotensive at baseline. We followed up these persons for one to 12 years (median, four years) for the development of hypertension. Multiple logistic risk analysis was used to estimate the independent contribution of physical fitness to risk of becoming hypertensive. After adjustment for sex, age, follow-up interval, baseline blood pressure, and baseline body-mass index, persons with low levels of physical fitness (72% of the group) had a relative risk of 1.52 for the development of hypertension when compared with highly fit persons. Risk of hypertension developing also increased substantially with increased baseline blood pressure.

Adult↗
PubMed1983

Changes in coronary heart disease risk factors associated with increased treadmill time in 753 men.

Associations between changes in treadmill time and changes in coronary heart disease risk factors were studied in 753 middle-aged men seen between 1978-1981 at the Cooper Clinic in Dallas, Texas. Men were free of known disease at baseline. Significant increases (p less than 0.01) in exercise habits and treadmill time were seen over the course of the study; average follow-up was 1.6 years. In bivariate analyses, increases in treadmill time and weight loss were associated with improvements (p less than 0.01) in risk factors. Multiple regression models were calculated for several risk factors with age, length of follow-up, change in weight, and change in treadmill time as independent variables. After controlling for confounding, increase in treadmill time was independently associated with decreases in the total cholesterol/high density lipoprotein-cholesterol ratio (p less than 0.01) and serum uric acid (p less than 0.05). High density lipoprotein-cholesterol rose with increase in treadmill time (p less than 0.05).

Adult↗
PubMed1983

Association between coronary heart disease risk factors and physical fitness in healthy adult women.

We examined associations between physical fitness and risk factors for coronary heart disease in healthy women ages 18-65 years. Physical fitness was objectively determined by the duration of a maximal treadmill exercise test. Six physical fitness categories (very poor to superior), specific within 10-year age increments, were established. Mean risk factor levels varied across categories, but so did potential confounders such as age and weight. Multiple linear regression modeling was used to control for the effects of age, weight and year of exam on coronary risk factors. After adjustment, physical fitness was independently associated with triglycerides (p less than 0.001), high-density lipoprotein cholesterol (HDL-C) (p less than or equal to 0.001), total cholesterol/HDL-C ratio (p less than or equal to 0.001), blood pressure (p less than or equal to 0.001) and cigarette smoking (p less than or equal to 0.001).

Adolescent↗
PubMed1980

The acute cardiac risk of strenuous exercise.

During a 65-month period, 2,935 adults (mean age, 37 years) kept computer logs of amount and intensity of exercise performed. A total of 374,798 person-hours of exercise, including 2,726,272 km or running and walking, was recorded. Two cardiac events and no deaths occurred during this period. Considered in age-specific categories, the maximum risk estimates (MREs) consistent with these data (upper 95% confidence limits) range from 0.3 to 2.7 events per 10,000 person-hours of exercise for men and 0.6 to 6.0 events per 10,000 person-hours for women. The MREs for women were higher because there were fewer women in the study. If exercise were performed three time per week for 30 minutes per session for a year, these results would lead to MREs from .002 to .027 events per person-year for men and .005 to .05 events per person-year for women. Actual risks are likely to be lower.

Adolescent↗