Medical News Tips From the Johns Hopkins Medical Institutions

Walking the golf course while pulling a cart provides safe and adequate exercise for most people with heart disease, according to researchers at Johns Hopkins and Wake Forest universities. But patients should check with their health care provider before teeing off, they say.

"Some less-fit patients with heart disease are in danger of exceeding a safe level of exercise and should be encouraged to monitor their intensity on the golf course, or consider using a motorized cart," says Devon Dobrosielski, M.S., lead author of the study and a clinical exercise physiologist at Hopkins. "For individuals who are more fit, golf may not provide enough exercise to increase physical fitness. However, regular golf participation would allow individuals to meet the moderate-level physical activity recommendations published by the American College of Sports Medicine, which may result in other positive health benefits."

Dobrosielski and colleagues followed 20 male golfers ages 49 to 78, half with heart disease. The researchers gave all participants a graded exercise test to determine their bodies' capacity for exercise, then matched each participant with heart disease with a healthy adult of similar age. Each pair completed nine holes of golf while pulling a cart and wearing portable devices to measure oxygen consumption during play and rest periods.

On average, players with heart disease worked at 57 percent of their exercise capacity, while their healthier counterparts worked at only 46 percent of their exercise capacity. Some patients with heart disease at times exceeded 100 percent of exercise capacity. Results were published in a recent issue of the Journal of Cardiopulmonary Rehabilitation.

Dobrosielski, D. et al., "The Metabolic Demand of Golf in Patients with Heart Disease and in Healthy Adults," Journal of Cardiopulmonary Rehabilitation, 2002; Vol. 22: pages 96-104.

TENNIS GETS AN ACE FOR HOLDING OFF HEART DISEASE

Men who start playing tennis in their youth and are good at it are likely to continue playing the sport for years, thereby keeping heart disease at bay well into middle-age, a Johns Hopkins study shows.

Researchers studied 1,019 male medical students at Hopkins between 1948 to 1964, asking them to rate their ability in tennis, golf, football, baseball and basketball during medical school and earlier, and giving them a standard physical examination. Through annual questionnaires, researchers assessed the participants' physical activity an average of 22 and 40 years later.

Those who reported greater ability in tennis in medical school had the highest participation in the sport in mid-life, with 33 percent playing within a week of the follow-up surveys, according to results published in the June 15 issue of the American Journal of Medicine. They had a lower incidence of cardiovascular disease and heart attack compared to those who didn't play tennis. Those good at golf also kept up the sport, but at a lower rate. Few to none of the men who played football, baseball and basketball participated in those sports in mid-life.

"Although some participants reported higher-level ability in other sports, tennis was the sport most frequently played through mid-life, which may explain its beneficial effects in preventing cardiovascular disease," says Michael J. Klag, M.D., M.P.H., senior author of the study and director of the Division of General Internal Medicine at Hopkins. "For physical activity to reduce the risk of cardiovascular disease, it must be sustained throughout life, which is something that should be considered by people planning physical education programs in middle schools and high schools."

Houston, T.K. et al, "Sports Ability in Young Men and the Incidence of Cardiovascular Disease," American Journal of Medicine 2002; Vol. 112: pages 689-695.