Work and Heart Disease

N EW understanding of the natural history of heart disease and better methods of treatment are reducing the aura of fear traditionally surrounding the cardiac patient. At the same time, modern technology is steadily lowering the physical demands of factory work, so that it is now evident that a majority of urban patients with heart disease can work safely.1 The physician, who is increasingly called upon to prescribe activity for his patients with heart disease, needs specific information about the stress of daily activities on which to base his advice. Artificial work situations, such as the Master 2-step test or treadmill exercise, involve high-energy expenditure for short periods of time and cannot simulate actual working conditions unless the doctor has specific knowledge of the demands of the patient's job.2 3 Many measurements of the energy cost of individual activities and a few studies of energy expenditure during several hours or days have been collected by Passmore and Durnin.4 However, these studies are of normal people in other countries and under other economic (Conditions. No studies have been published of working energy expenditure of patients with heart disease. The present study therefore was designed to measure the energy expenditure of factory workers with heart disease, to observe various aspects of cardiovascular function under actual working condi-