In this series, although women comprised the minority of patients referred with chest pain, a diagnosis of normal coronary arteries was five times more common in women than men. Risk factor analysis and exercise testing were of limited value in predicting coronary artery disease in women. There was no sex bias regarding revascularisation procedures, and outcome was similar. A diagnosis of non-cardiac chest pain in patients with normal coronary arteries was of little benefit to the patient with regard to morbidity.

Five computed tomography (CT) scans were taken at measured intervals of the legs and arms of young (n = 7) and elderly (n = 13) men. Cross-sectional areas (CSA) of the total limb, muscle plus bone and bone were measured in each scan, and skin plus subcutaneous tissue areas were calculated by subtraction. In addition, in the arm scans the CSA of the extensor and flexor compartments were measured, and in the leg the CSA of the plantar flexor compartment. A value for lean muscle within these compartments was calculated by excluding non-muscle tissue using density measurements based on Hounsfield units. Related volumes for the various components were also calculated using geometric formulae. The results showed that elderly limbs were of a similar overall size as the young, but elderly muscles were smaller (28-36%) with greater amounts of non-muscle tissue located within a muscle, particularly in the plantar flexors (81% more than in the young). Elderly arms had a greater amount of skin plus subcutaneous tissue than the young, but there was no difference in the legs. Muscle volumes were similar to in vitro results reported from cadaver studies and can be predicted from single mid-limb CT scans using regression equations. These results illustrate that, due to the substantially reduced amount of 'pure' muscle tissue in the elderly, comparisons of relative strength with other populations may be misleading unless appropriate measurements of muscle size are considered. Methods to estimate in vivo physiological CSA, which is considered the best means of normalizing strength, have been demonstrated in this study.

Oxygen uptake-velocity regression equations were developed for floor and level treadmill walking by having two groups of men, aged 19-29 years (n = 20) and 55-66 years (n = 22), walk at four self-selected paces, from "rather slowly" to "as fast as possible". A two-variable quadratic model relating VO2 (ml X kg-1 X min-1) to velocity (m X s-1) was adopted for prediction purposes. However, age and fatness significantly (P less than 0.05) interacted with treadmill walking speed, while age alone significantly interacted with floor speed. In addition, a significant difference was found between the energy cost of floor and treadmill walking. For example at the normal walking speed of 1.33 m X s-1, the energy cost for the treadmill (age 55-66 years) was 10.58 ml X kg-1 X min-1 and for the floor, 11.04 ml X kg-1 X min-1 (P less than 0.05). Four quadratic equations are therefore presented, one each for floor and treadmill in each of the two age-groups. The percent variance explained was between 87 and 95% for each of these equations.

No abstract

Cross-sectional studies have compared the oxygen uptake (VO2) kinetics during the on-transient of moderate intensity exercise in older and younger adults. The slower values in the older adults may have been due to an age-related reduction in the capacity for O2 transport or alternatively a reduced intramuscular oxidative capacity. We studied: (1) the effects of ageing on VO2 kinetics in older adults on two occasions 9 years apart, and (2) the effect of hyperoxia on VO2 kinetics at the second test time. After a 9 year period, follow-up testing was undertaken on seven older adults (78 +/- 5 years, mean +/- S.D.). They each performed six repeats of 6 min bouts of constant-load cycle exercise from loadless cycling to 80% of their ventilatory threshold. They breathed one of two gas mixtures (euoxia: inspired O2 fraction, FI,O2, 0.21; hyperoxia: FI,O2, 0.70) on different trials determined on a random basis. Breath-by-breath VO2 data were time aligned and ensemble averaged. VO2 kinetics, modelled with a single exponential from phase 2 onset (+20 s) to steady state and described by the exponential time constant (tau) were compared with data collected from the same adults 9 years earlier. One-way repeated measures analysis of variance revealed that tau was slowed significantly with age (from 30 +/- 8 to 46 +/- 10 s), but was unaffected by hyperoxia (43 +/- 15 s). We concluded that: (1) in older adults studied longitudinally over a 9 year period, the on-transient VO2 kinetics are slowed, in agreement with, but to a greater extent, than from cross-sectional data; and (2) the phase 2 time constant (tau) for these older adults was not accelerated by hyperoxic breathing. Thus the expected hyperoxia-induced increase in the capacity for O2 transport was not associated with faster on-transient VO2 kinetics suggesting either that O2 transport may not limit VO2 kinetics during the 8th decade, or that O2 transport was not improved with hyperoxia.