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Background: It has been shown that short-term exercise training improves insulin resistance parameters in patients with ischaemic heart disease. The effects of such a rehabilitation programme in patients with hypertension have not been well established., Aim: To assess whether short-term endurance training after coronary artery bypass grafting (CABG) may improve metabolic parameters and reduce blood pressure in patients with hypertension., Methods: The study group consisted of 30 male patients (15 with hypertension and 15 normotensive) aged 55+/-2.1 years who underwent CABG 1 to 6 months before the initiation of a 3-week endurance training. Glucose, insulin and C-peptide blood levels as well as binding and degradation of 125I-insulin by erythrocyte receptors were assessed before and after the training programme. The effects of training on blood pressure values were also evaluated., Results: A significant improvement (p<0.01) in the insulin resistance parameters, i.e. binding and degradation of labelled insulin was noted only in patients with hypertension. This was accompanied by a significant (p<0.05) increase in the HDL-cholesterol level. In the subgroup with hypertension, both the exercise systolic and diastolic pressures decreased significantly (p<0.05 and p<0.01, respectively), and similar changes were noted in the resting systolic and diastolic blood pressures values (p<0.05)., Conclusions: Rehabilitation after CABG based on the endurance training was especially effective in patients with hypertension in whom beneficial changes in some metabolic risk factors of ischaemic heart disease as well as the reduction in the blood pressure values were observed.

Purpose: This study was directed toward establishing whether and to what extent, short-term endurance training influences the insulin blood level, and the binding and degradation of 125I-insulin by erythrocyte receptors in patients undergoing rehabilitation after myocardial infarction., Methods: The study was conducted in a group of 60 patients who had had myocardial infarction within the past 1.5 to 3 months and who did not have arterial hypertension and diabetes mellitus. All the patients took a symptom-limited cardiopulmonary exercise test. Before and after the test, venous blood was collected to determine lactic acid and insulin blood levels as well as the binding and degradation of 125I-insulin. The study group was randomized into two subgroups. One subgroup entered into a 3-week in-patient rehabilitation course. The control group was discharged from the hospital and was given no recommendations for physical exercise. The same investigation was repeated 3 weeks later., Results: In the patients (50%) with hyperinsulinemia (insulin resistance index, > 10 microIU/mL), which was detected during the first investigation, insulin blood level decreased from 23.9 +/- 4.4 to 15.0 +/- 1.9 microIU/mL (P < 0.05) after rehabilitation, whereas insulin binding increased from 0.67 +/- 0.05 to 0.85 +/- 0.08 pg 125I/10(11) erythrocytes (P < 0.05). In the control group, which included normal subjects and those with hyperinsulinemia, the results obtained during the first and second investigations showed no statistically significant changes when compared., Conclusions: The results suggest that a 3-week endurance training period during rehabilitation after myocardial infarction reduces insulin resistance in patients with hyperinsulinemia.

We have investigated the influence of physical training on exercise-induced changes in free radical activity in patients after myocardial infarction. Seventeen patients admitted to the cardiac rehabilitation center performed a bicycle ergometry before and after a 3-week endurance training program. The oxygen consumption and carbon dioxide production were measured and the ECG and the systemic blood pressure were monitored during the tests. Blood samples for acid-base equilibrium, lactic acid levels and hydrogen peroxide concentrations were collected directly before and after each exercise test. Exercise-induced increases in systolic blood pressure, heart rate and rate-pressure product as well as lactic acid concentrations were significantly less marked during the bicycle ergometry performed after the rehabilitation program. During the initial exercise test hydrogen peroxide levels increased significantly from 7.15+/-0.74 micromol/l before to 9.09+/-1.04 micromol/l 3 min after the test (P=0.0229). In contrast, no significant changes in hydrogen peroxide concentrations were observed during the exercise test performed after the training (6.31+/-1.05 micromol/l before the test, 5.85+/-1.08 micromol/l after the test, P=0.201). These observations suggest that physical training may have a beneficial influence on free radicals' generation in patients after myocardial infarction.