Influência da idade e do sexo na força muscular respiratória

The purpose of the study was to assess respiratory muscle strength (RMS) by means of manovacuometry among women and men aged 40-89, checking whether there are differences in maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values between same-sex subjects of different ages and between same-age subjects of different sex. One hundred subjects were studied (50 men, 50 women); subjects with pneumopathologies, practising regular physical activities, smokers and former smokers were excluded. Data were statistically analysed. Results show lesser both MIP and MEP values in women than same-aged men (p<0,001); and, among men and women, a progressive, significant reduction (p<0,01) in values of respiratory pressure at every decade in age advance. These results allow concluding that age and sex do influence RMS.Este estudo teve como objetivo avaliar a força muscular respiratória (FMR) por meio de manovacuometria de homens e mulheres com idade entre 40 e 89 anos, verificando se há diferenças nos valores da pressão inspiratória máxima (PImáx) e pressão expiratória máxima (PEmáx) entre indivíduos do mesmo sexo de diferentes idades, e entre os sexos da mesma idade. Foram estudados 100 indivíduos (50 homens e 50 mulheres), sendo excluídos indivíduos com pneumopatologias, praticantes regulares de atividade física, fumantes e ex-fumantes. Os dados foram analisados estatisticamente. Os resultados mostram menor valor tanto da PImáx como da PEmáx nas mulheres em relação aos homens da mesma idade (p<0,001), e redução progressiva e significativa (p<0,01) com o avançar de cada década nos valores das pressões respiratórias em ambos os sexos. Esses resultados permitem concluir que a idade e o sexo influenciam diretamente a FMR

Análise do controle autonômico cardíaco e do metabolismo muscular durante o exercício descontínuo dinâmico e resistido em homens jovens e idosos

The thesis consisted of three studies described below. Study I, which aimed to investigate the effect of aging on kinetic responses of heart rate (HR) and oxygen consumption (VO2) during rest-exercise (ontransient) and exercise-recovery transitions (off-transient), and to investigate the influence of exercise intensity (mild and moderate) on the kinetic parameters of these variables. 28 apparently healthy men were evaluated, and 14 constituted the young group (YG) and 14 the elderly group (EG). The evaluation consisted of applying an incremental exercise testing of ramp protocol on cycle-ergometer (IET-R) to determine the maximum power (MP) and discontinuous exercise test on a cycle ergometer (DET-C), which started with an initial power load of 10% of MP with subsequent increase of 10% until exhaustion. Were recorded ventilatory and metabolic variables, the HR and blood lactate at rest and during exercise. The lactate threshold (LT) was closed between the groups (approximately 30% of MP). The EG showed higher values of the kinetic responses, both on and off transitions of HR and VO2 (p<0.05), and the values were higher in moderate compared to mild in YG (p<0.05). We conclude that the elderly have slower kinetic responses of HR and VO2 in relation to young and that at moderate intensity; the kinetic responses were slower in relation to mild intensity in young. Following, the study II aimed to investigate the behavior of the heart rate variability (HRV) responses during a discontinuous resistance exercise (RE) protocol and check whether they agree with the blood lactate responses in the determination of anaerobic threshold (AT) in apparently healthy young and elderly. For this proposal, in the same volunteers in the study I, was applied the test of one repetition maximum (1RM) on the leg press 45º and the discontinuous exercise test on the leg press 45 (DET-L), initiated in 10% of 1RM subsequent increments of 10% until exhaustion, and the HR and blood lactate were obtained at rest and during exercise. The AT was determined at approximately 30% of 1RM in both groups and both methods of analysis (blood lactate and HRV), the HRV index decreased with increasing load and stabilized from the load corresponding to AT in both groups, additionally the blood lactate remained practically stable until the load of AT, and increased significantly after this intensity. The EG had lower HRV values in lower loads of AT, and lower values of HR and blood lactate in loads above of AT in relation to the YG. We conclude that the HRV responses to determine the AT are according to blood lactate, and that the increase in load during the discontinuous RE promoted gradual vagal withdrawal followed by sympathetic activation in both young and the elderly, however, these responses are attenuated with the aging process. Finally, the study III, aimed to determine the AT during discontinuous dynamic and resistance exercise protocol by analyzing blood lactate and HRV in healthy older adults, comparing the cardiovascular, metabolic and autonomic variables between these two exercise modalities. We evaluated the elderly group of individuals during the tests: IET-R, DET-C, 1RM and DET-L. The AT within about 30% of maximum intensity in both the DET-C and DET-L by both methods (blood lactate and HRV). There were no differences in HRV variables between the modalities of exercise and a significant increase in systolic blood pressure and blood lactate after AT load in the DET-L. We conclude that HRV was effective in determining the AT and that the parasympathetic modulation responses were similar between dynamic and resistance exercise.Universidade Federal de Minas GeraisA tese constou de 3 estudos descritos a seguir. Estudo I, que teve como objetivo investigar o efeito do envelhecimento nas respostas cinéticas da frequência cardíaca (FC) e do consumo de oxigênio (VO2) durante as transições repouso-exercício (fase-on) e exercício-recuperação (fase-off), além de verificar a influência da intensidade do exercício (leve e moderada) sobre os parâmetros cinéticos destas variáveis. 28 homens aparentemente saudáveis foram avaliados, sendo que 14 constituíram o grupo de jovens (GJ) e 14 o grupo de idosos (GI). A avaliação foi constituída da aplicação de um teste de esforço incremental do tipo rampa (TEI-R) em cicloergômetro para determinar a potência máxima (PM) e teste de exercício descontínuo no cicloergômetro (TED-C), sendo este último iniciado com carga inicial de 10% da PM com aumentos subsequentes de 10% até a exaustão. Foram registradas as variáveis ventilatórias e metabólicas, a FC e a lactacidemia em repouso e durante o esforço. O limiar de lactato (LL) foi verificado em cargas relativas similares entre os grupos (aproximadamente em 30% da PM). O GI apresentou maiores valores das respostas cinéticas, tanto na transição on como off da FC e do VO2 (p<0,05), e os valores foram maiores na intensidade moderada em comparação à leve no GJ (p<0,05). Concluímos que os idosos tem respostas cinéticas mais lentas da FC e do VO2 em relação aos jovens e que em intensidade moderada, as respostas cinéticas foram mais lentas em relação à intensidade leve nos jovens. Na sequência, o estudo II objetivou investigar o comportamento das respostas da variabilidade da frequência cardíaca (VFC) durante um protocolo de exercício resistido (ER) descontínuo e verificar se estas são concordantes com as respostas de lactacidemia na determinação do limiar anaeróbio (LA) em jovens e idosos aparentemente saudáveis. Para tal proposta, nos mesmos voluntários do estudo I, foi aplicado o teste de uma repetição máxima (1RM) no leg press 45º e o teste de exercício descontínuo no leg press 45º (TED-L), iniciado em 10% de 1RM com incrementos subsequentes de 10% até a exaustão, sendo a FC e a lactacidemia obtidas no repouso e no exercício. O LA foi determinado em aproximadamente 30% da 1RM em ambos os grupos e em ambos os métodos de análise (lactacidemia e VFC), os índices da VFC diminuíram com aumento da carga e se estabilizaram a partir da carga do LA em ambos os grupos, adicionalmente, a lactacidemia manteve-se praticamente estável até a carga do LA, aumentando significativamente após esta intensidade. O GI apresentou valores reduzidos da VFC nas cargas inferiores ao LA, e valores reduzidos de FC e lactacidemia nas cargas acima do LA, em relação ao GJ. Concluímos que as respostas de VFC para determinar o LA estão de acordo com a lactacidemia, e que o aumento das cargas durante o ER descontínuo, promoveu gradual retirada vagal, seguida pela ativação simpática, tanto nos jovens como nos idosos, no entanto, estas respostas são atenuadas com o processo de envelhecimento. Finalmente o estudo III, teve como objetivo determinar o LA em protocolo de exercício descontínuo dinâmico e resistido por meio da análise da lactacidemia e da VFC em idosos saudáveis, comparando as variáveis cardiovasculares, metabólicas e autonômicas entre estas duas modalidades. Foram avaliados os indivíduos do grupo idoso durante os testes: TEI-R, TED-C, 1RM e TED-L. O LA ocorreu em aproximadamente 30% da intensidade máxima tanto no TED-C como no TED-L, por ambos os métodos (lactacidemia e VFC). Não houve diferenças em relação às variáveis da VFC entre as modalidades de exercício e houve aumento significativo da pressão arterial sistólica e lactacidemia após a carga do LA no TED-L. Concluímos que a VFC foi eficaz na determinação do LA e que as respostas da modulação parassimpática foram semelhantes entre o exercício dinâmico e resistido

Interação da variabilidade da freqüência cardíaca e do lactato sanguíneo durante o exercício resistido em idosos saudáveis

The anaerobic threshold (AT) is an important parameter for prescription of physical exercise in various clinical conditions, because represent the intensity of effort at which the aerobic metabolism begins to be supplemented by anaerobic metabolism for the production of energy. In this context, different methods to identify AT have been described, for example by analysis of blood lactate and the respiratory gas exchanges, yet such methods require expensive equipment and materials. Low cost non-invasive techniques such as heart rate variability (HRV) have been proposed to determine the AT; however, they are most commonly applied in discontinuous protocols on a cycle ergometer or treadmill. Therefore, the objectives of this study were to evaluate the behavior of HRV and blood lactate during resistance exercise (RE) with increasing resistances at a percentage of one repetition maximum (1RM), and investigate the existence of an aerobic-anaerobic transition point in the metabolism during lower leg exercise in healthy older adults. Secondarily, our objective was to evaluate the relationship between different methods, as well as the degree of concordance between the same. Ten healthy men ranging in age from 60 to 70 years old (mean and SD: 64 ± 4 years, 166 ± 3 cm, 70 ± 7 kg), underwent medical examination, ergonomic testing and laboratory exams (hemogram, triglycerides, total and fractional cholesterols, glycemia and uric acid. The protocol for RE was administered on Leg Press 45° (Pró-Fitness) equipment. The protocol resistance loads used were determined by 1RM test; the volunteer complete one full cycle on the equipment at the maximum resistance load that the volunteer could achieve, and the resistance load increases were calculated from this test value at rates of 10% of 1RM until a 30% increase and then at increments of 5% until exhaustion. At each percentage increase of effort, the volunteer performed 4 minutes of exercise followed a rest interval of 15 minutes. Heart rate was captured throughout the protocol by a Polar Vantage Heart rate monitor connected to a Polar Advantage Interface that transmitted the data in real time to a Soyo Notebook computer. The blood samples were collected before the initial effort and immediately after the end of each resistance load. Blood lactate and HRV were analyzed at rest conditions with the volunteer positioned on the equipment and at each percentage of effort. The indexes utilized for HRV analysis were RMSSD, RMSM, SD1, SD2 and SD1/SD2 ratio. To identify the aerobic-anaerobic transition point, blood lactate concentrations were used (gold standard) as well as SD1 and RMSSD indexes; and these points were denominated as lactate threshold (LT), SD1 threshold (SD1T) and RMSSD threshold (RMSSDT). The level of significance for all statistical tests was set at 5%. The principal result showed that the mean of the RMSSD, RMSM and SD1 indexes reduced significantly at 30% 1RM in relation to the rest condition, and blood lactate presented an exponential increase at 30% 1RM, that was significantly greater in relation to the rest condition at 35%. There was no significant difference in relation to absolute and relative values for resistance loads at which the aerobic-anaerobic transition point was identified (absolute values: LT = 101 ± 32 kg, SD1T = 96 ± 28 kg, RMSSDT = 97 ± 21 kg; Relative values: LT = 30 ± 6%, SD1T = 29 ± 6%, RMSSDT = 29 ± 5%). Additionally, good concordance and good correlation were found between LT and RMSSDT (r = 0.78) and between LT and SD1T (0.81). It can be concluded that the behavior of HRV and blood lactate change markedly at 30% 1RM during resistance exercise on the Leg Press 45°. It was possible at this percentage to identify the aerobic-anaerobic metabolism transition point by blood lactate as well as by HRV in healthy older men.Universidade Federal de Minas Geraisfísico em várias condições clínicas, pois representa a intensidade de esforço a qual o metabolismo aeróbio passa a ser suplementado pelo metabolismo anaeróbio para a produção de energia. Neste contexto, tem sido descritos diferentes métodos para a determinação do LA por meio de análises da concentração sangüínea de lactato e das trocas gasosas respiratórias, entretanto, tais métodos necessitam de equipamentos e materiais de alto custo. Desta forma, técnicas não-invasivas e de baixo custo como as análises da variabilidade da freqüência cardíaca (VFC) têm sido propostas para determinação do LA, no entanto, em sua grande maioria tem sido aplicadas em protocolos descontínuos em cicloergômetro ou esteira. Assim, os objetivos deste estudo foram avaliar o comportamento da VFC e do lactato sangüíneo durante o exercício físico resistido (EFR) com o incremento de resistência em percentual de uma repetição máxima (1RM), e investigar a existência de um ponto de transição do metabolismo aeróbio-anaeróbio durante o exercício resistido de membros inferiores em idosos saudáveis. Secundariamente, tivemos como objetivo avaliar o relacionamento entre os diferentes métodos, bem como o grau de concordância dos mesmos. Foram avaliados 10 homens saudáveis com faixa etária entre 60 e 70 anos (média e DP: 64 ± 4 anos, 166 ± 3 cm, 70 ± 7 kg), sendo submetidos à avaliação médica, teste ergométrico e solicitado exames laboratoriais (hemograma, triglicérides, colesterol total e frações, glicemia e ácido úrico). O protocolo de EFR foi aplicado no equipamento Leg Press 45° (Pró-Fitness) sendo que para a determinação das cargas que seriam utilizas, foi realizado previamente o teste de 1RM, no qual o voluntário fez apenas um ciclo completo do movimento no equipamento com a carga máxima suportada, e a partir deste valor, foi estabelecido o protocolo de incremento de cargas, partindo de 10% de 1RM, com acréscimos subseqüentes de 10% até a carga de 30%, e de 5% a partir desta, até a exaustão voluntária. Em cada percentual de esforço, o voluntário foi submetido a 4 minutos de exercício e 15 minutos de repouso pós-esforço. A freqüência cardíaca (FC) foi captada durante todo protocolo por um cardiofreqüencímetro (Polar Vantage) interligado a uma interface (Polar Advantage), que transmitia os dados online para o computador (Notebook Soyo). Para a analise do lactato, foram coletadas amostras de sangue previamente ao início do esforço e imediatamente após o término de cada carga aplicada. Tanto o lactato sangüíneo quanto a VFC foram analisados nas condições de repouso, com o voluntário posicionado no equipamento, e em cada percentual de esforço. Os índices utilizados para a análise da VFC foram o RMSSD, RMSM, SD1, SD2 e a razão SD1/SD2. Para a identificação do ponto de transição aeróbio-anaeróbio as concentrações de lactato sangüíneo foram utilizadas como padrão ouro, sendo também utilizados os índices SD1 e RMSSD; estes pontos foram denominados de limiar de lactato (LL), limiar de SD1 (LSD1) e limiar de RMSSD (LRMSSD). O nível de significância adotado em todos testes estatísticos foi de 5%. Os principais resultados mostraram que os índices RMSSD, RMSM e SD1 reduziram significativamente a partir dos 30% de 1RM em relação à condição de repouso, tal como o lactato sangüíneo apresentou aumento exponencial a partir dos 30% de 1RM. Não houve diferença significativa para os valores absolutos e relativos da carga na qual o ponto de transição aeróbio-anaeróbio foi identificado (valores absolutos: LL = 101 ± 32 kg, LSD1 = 96 ± 28 kg, LRMSSD = 97 ± 21 kg; valores relativos: LL = 30 ± 6%, LSD1 = 29 ± 6%, LRMSSD = 29 ± 5%). Adicionalmente, boa concordância e fortes correlações foram encontradas entre o LL e LRMSSD (r = 0,78) e entre o LL e LSD1 (0,81). Conclui-se que o comportamento da VFC e do lactato sangüíneo se modifica marcantemente a partir dos 30% de 1RM durante o exercício resistido realizado no Leg Press a 45°, sendo que neste percentual foi possível identificar o ponto de transição do metabolismo aeróbio-anaeróbio, tanto por meio da lactacidemia como pela VFC em idosos saudáveis

Arterial stiffness in type 2 diabetes: determinants and indication of a discriminative value

OBJECTIVES: To identify the clinical discriminative value and determinants of arterial stiffness in individuals with type 2 diabetes mellitus (T2DM). METHODS: This prospective cohort study included 51 individuals (53.57±9.35 years) diagnosed with T2DM (stage glucoseX126 mg/dL; diagnostic time: 87.4±69.8 months). All participants underwent an initial evaluation of personal habits, medications, and history; arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor; and blood laboratory analysis. A statistical analysis was performed using SPSS software, and values of pp0.05 were considered significant. RESULTS: A cut-off cfPWV value of 7.9 m/s was identified for T2DM [Sensitivity (SE): 90% and Specificity (SP): 80%]. A subgroup analysis revealed higher glycated hemoglobin (Hb1Ac) (p=0.006), obesity (p=0.036), and dyslipidemia (p=0.013) than those with cfPWV X7.9 m/s. Multivariate analysis identified higher stage glucose (p=0.04), Hb1Ac (p=0.04), hypertension (p=0.001), and dyslipidemia (p=0.01) as determinant factors of cfPWV; positive and significant correlation between cfPWV and glucose (r=0.62; p=0.0003) and Hb1Ac (r=0.55; p=0.0031). CONCLUSIONS: In T2DM, an indicator of the discriminative value of arterial stiffness was cfPWV of 7.9 m/s. Clinical findings and comorbidities, such as hypertension, glucose, poor glycemic control, and dyslipidemia, were associated with and were determinants of arterial stiffness in T2DM. Reinforcement of monitoring risk factors, such as hypertension, dyslipidemia, and glycemic control, seems to be essential to the process of arterial stiffening. Confirmation of this discriminative value in larger populations is recommended

Prevalence of reduced respiratory muscle strength in institutionalized elderly people

CONTEXT AND OBJECTIVES: Respiratory muscle strength is relevant to the clinical situation of elderly patients, particularly those presenting with respiratory or cardiac diseases. The objectives of this study were to evaluate the respiratory muscle strength of institutionalized elderly women, compare this with predicted values for the Brazilian population and calculate the correlation with age and anthropometric characteristics. DESIGN AND SETTING: Cross-sectional study at the Department of Physiotherapy of Universidade Camilo Castelo Branco. METHODS: The participants were 56 institutionalized elderly women (74.87 ± 10.55 years of age), evaluated in eight institutions in three cities in the central region of the State of São Paulo, between January 2005 and March 2006. They were separated into three subgroups according to age: 60-69 years (n = 20), 70-79 (n = 18) and 80-89 years (n = 18). Maximal respiratory pressures were obtained using a manovacuometer. The values obtained were compared between subgroups and with predicted values. Correlation analysis was used to evaluate age, weight, height and body mass index in relation to maximal respiratory pressures. The significance level was P < 0.05. RESULTS: No significant differences in maximal respiratory pressures were seen between the three subgroups. The maximal respiratory pressures were significantly lower in the three subgroups, compared with predicted values. Negative correlations between maximal respiratory pressures and age and positive correlations in relation to weight, height and body mass index were found. CONCLUSIONS: Respiratory muscle strength was markedly reduced in institutionalized 60 to 89-year-old women and the values demonstrated correlations with age and anthropometric characteristics

INFLUÊNCIA DA ATIVIDADE FÍSICA NA QUALIDADE DE VIDA DE IDOSAS PORTADORAS DE OSTEOPOROSE

O objetivo deste estudo foi avaliar e comparar a qualidade de vida entre idosas portadoras de osteoporose praticantes de atividade física e sedentárias. Foram estudadas 28 idosas com diagnóstico clínico de osteoporose (76,10 ± 3,26 anos), sendo separadas em dois grupos; grupo 1 (G1): 15 pacientes sedentárias; e grupo 2 (G2): 13 pacientes que participavam de um programa de atividade física do serviço de Fisioterapia do Instituto de Ortopedia e Traumatologia do HC/ FMUSP. As participantes do G2 realizaram sessões de exercícios com duração de uma hora, duas vezes por semana, num período de oito meses. Foram aplicados dois questionários para avaliar a qualidade de vida em ambos os grupos, o Osteoporosis Assessment Questionnaire (OPAQ) e o Medical Outcomes StudyShort form Health Survey (MOS SF-36). O teste de Mann-Whitney foi utilizado para comparar os resultados entre os grupos, considerando e#1048671;=0,05. Em relação ao questionário MOS SF-36, o G2 apresentou melhor pontuação nos domínios: saúde geral, capacidade funcional, aspectos sociais, aspectos físicos e aspectos emocionais em comparação ao G1, porém não houve diferenças significativas em relação aos domínios saúde mental e dor. Quanto ao questionário OPAQ, foi verificado melhor pontuação em todos os domínios (saúde geral, aspectos físicos, aspectos psicológicos, interação social, sintomas, dificuldades relacionadas ao trabalho, e imagem corporal) do G2 em relação ao G1. Os resultados indicam que a prática de atividade física realizada regularmente pode representar importante instrumento na melhora da qualidade de vida de pacientes idosas portadoras de osteoporose. Palavras-chave: Osteoporose; Qualidade de vida; Atividade física

Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease

BACKGROUND: A synchronism exists between the respiratory and cardiac cycles. However, the influence of the inspiratory muscle weakness in chronic obstructive pulmonary disease (COPD) on cardiac autonomic control is unknown. The purpose of the present investigation was to evaluate the influence of respiratory muscle strength on autonomic control in these patients. METHODS: Ten chronic obstructive pulmonary disease patients (69±9 years; FEV(1)/FVC 59±12% and FEV(1) 41±11% predicted) and nine age-matched healthy volunteers (64±5 years) participated in this study. Heart-rate variability (HRV) was obtained at rest and during respiratory sinusal arrhythmia maneuver (RSA-M) by electrocardiograph. RESULTS: Chronic obstructive pulmonary disease patients demonstrated impaired cardiac autonomic modulation at rest and during RSA-M when compared with healthy subjects (p<0.05). Moreover, significant and positive correlations between maximal inspiratory pressure (MIP) and the inspiratory-expiratory difference (ΔIE) (r = 0.60, p<0.01) were found. CONCLUSION: Patients with chronic obstructive pulmonary disease presented impaired sympathetic-vagal balance at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in chronic obstructive pulmonary disease. Based on this evidence, future research applications of respiratory muscle training may bring to light a potentially valuable target for rehabilitation

Expiratory Flow Limitation at Different Exercise Intensities in Coronary Artery Disease

Introduction. Expiratory flow limitation (EFL) during moderate intensity exercise is present in patients with myocardial infarction (MI), whereas in healthy subjects it occurs only at a high intensity. However, it is unclear whether this limitation already manifests in those with stable coronary artery disease (CAD) (without MI). Materials and Methods. Forty-one men aged 40–65 years were allocated into (1) recent MI (RMI) group (n = 8), (2) late MI (LMI) group (n = 12), (3) stable CAD group (n = 9), and (4) healthy control group (CG) (n = 12). All participants underwent two cardiopulmonary exercise tests at a constant workload (moderate and high intensity), and EFL was evaluated at the end of each exercise workload. Results. During moderate intensity exercise, the RMI and LMI groups presented with a significantly higher number of participants with EFL compared to the CG (p0.05). Moreover, EFL was only present in MI groups during moderate intensity exercise, whereas at high intensity all groups presented EFL. Regarding the degree of EFL, the RMI and LMI groups showed significantly higher values at moderate intensity exercise in relation to the CG. At high intensity exercise, significantly higher values for the degree of EFL were observed only in the LMI group. Conclusion. The ventilatory limitation at moderate intensity exercise may be linked to the pulmonary consequences of the MI, even subjects with preserved cardiac and pulmonary function at rest, and not to CAD per se

Circulatory and Ventilatory Power: Characterization in Patients with Coronary Artery Disease

Background: Circulatory power (CP) and ventilatory power (VP) are indices that have been used for the clinical evaluation of patients with heart failure; however, no study has evaluated these indices in patients with coronary artery disease (CAD) without heart failure. Objective: To characterize both indices in patients with CAD compared with healthy controls. Methods: Eighty-seven men [CAD group = 42 subjects and healthy control group (CG) = 45 subjects] aged 40–65 years were included. Cardiopulmonary exercise testing was performed on a treadmill and the following parameters were measured: 1) peak oxygen consumption (VO2), 2) peak heart rate (HR), 3) peak blood pressure (BP), 4) peak rate-pressure product (peak systolic HR x peak BP), 5) peak oxygen pulse (peak VO2/peak HR), 6) oxygen uptake efficiency (OUES), 7) carbon dioxide production efficiency (minute ventilation/carbon dioxide production slope), 8) CP (peak VO2 x peak systolic BP) and 9) VP (peak systolic BP/carbon dioxide production efficiency). Results: The CAD group had significantly lower values for peak VO2 (p < 0.001), peak HR (p < 0.001), peak systolic BP (p < 0.001), peak rate-pressure product (p < 0.001), peak oxygen pulse (p = 0.008), OUES (p < 0.001), CP (p < 0.001), and VP (p < 0.001) and significantly higher values for peak diastolic BP (p = 0.004) and carbon dioxide production efficiency (p < 0.001) compared with CG. Stepwise regression analysis showed that CP was influenced by group (R2 = 0.44, p < 0.001) and VP was influenced by both group and number of vessels with stenosis after treatment (interaction effects: R2 = 0.46, p < 0.001). Conclusion: The indices CP and VP were lower in men with CAD than healthy controls