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Zhang Y, Wang X, Pathiravasan CH, Spartano NL, Lin H, Borrelli B, Benjamin EJ, McManus DD, Larson MG, Vasan RS, Shah RV, Lewis GD, Liu C, Murabito JM, Nayor M. Association of Smartwatch-Based Heart Rate and Physical Activity With Cardiorespiratory Fitness Measures in the Community: Cohort Study. J Med Internet Res 2024; 26:e56676. [PMID: 38870519 DOI: 10.2196/56676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Resting heart rate (HR) and routine physical activity are associated with cardiorespiratory fitness levels. Commercial smartwatches permit remote HR monitoring and step count recording in real-world settings over long periods of time, but the relationship between smartwatch-measured HR and daily steps to cardiorespiratory fitness remains incompletely characterized in the community. OBJECTIVE This study aimed to examine the association of nonactive HR and daily steps measured by a smartwatch with a multidimensional fitness assessment via cardiopulmonary exercise testing (CPET) among participants in the electronic Framingham Heart Study. METHODS Electronic Framingham Heart Study participants were enrolled in a research examination (2016-2019) and provided with a study smartwatch that collected longitudinal HR and physical activity data for up to 3 years. At the same examination, the participants underwent CPET on a cycle ergometer. Multivariable linear models were used to test the association of CPET indices with nonactive HR and daily steps from the smartwatch. RESULTS We included 662 participants (mean age 53, SD 9 years; n=391, 59% women, n=599, 91% White; mean nonactive HR 73, SD 6 beats per minute) with a median of 1836 (IQR 889-3559) HR records and a median of 128 (IQR 65-227) watch-wearing days for each individual. In multivariable-adjusted models, lower nonactive HR and higher daily steps were associated with higher peak oxygen uptake (VO2), % predicted peak VO2, and VO2 at the ventilatory anaerobic threshold, with false discovery rate (FDR)-adjusted P values <.001 for all. Reductions of 2.4 beats per minute in nonactive HR, or increases of nearly 1000 daily steps, corresponded to a 1.3 mL/kg/min higher peak VO2. In addition, ventilatory efficiency (VE/VCO2; FDR-adjusted P=.009), % predicted maximum HR (FDR-adjusted P<.001), and systolic blood pressure-to-workload slope (FDR-adjusted P=.01) were associated with nonactive HR but not associated with daily steps. CONCLUSIONS Our findings suggest that smartwatch-based assessments are associated with a broad array of cardiorespiratory fitness responses in the community, including measures of global fitness (peak VO2), ventilatory efficiency, and blood pressure response to exercise. Metrics captured by wearable devices offer a valuable opportunity to use extensive data on health factors and behaviors to provide a window into individual cardiovascular fitness levels.
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Affiliation(s)
- Yuankai Zhang
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | - Xuzhi Wang
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | | | - Nicole L Spartano
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Honghuang Lin
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, United States
| | - Emelia J Benjamin
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Departments of Medicine and Epidemiology, Boston University Chobanian & Avedisian School of Medicine and School of Public Health, Boston, MA, United States
| | - David D McManus
- Cardiology Division, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Martin G Larson
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
| | - Ramachandran S Vasan
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Departments of Medicine and Epidemiology, Boston University Chobanian & Avedisian School of Medicine and School of Public Health, Boston, MA, United States
| | - Ravi V Shah
- Cardiology Division, Vanderbilt Translational and Clinical Research Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Gregory D Lewis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Pulmonary Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Chunyu Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | - Joanne M Murabito
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Matthew Nayor
- Sections of Cardiology and Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
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Kunutsor SK, Kaminsky LA, Lehoczki A, Laukkanen JA. Unraveling the link between cardiorespiratory fitness and cancer: a state-of-the-art review. GeroScience 2024:10.1007/s11357-024-01222-z. [PMID: 38831183 DOI: 10.1007/s11357-024-01222-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/24/2024] [Indexed: 06/05/2024] Open
Abstract
Cardiorespiratory fitness (CRF) not only reflects an individual's capacity to perform physical activities but also encapsulates broader effects on the basic biology of aging. This review aims to summarize the evidence on the influence of CRF on overall and site-specific cancer risks. It delves into the biological mechanisms through which CRF may exert its effects, explores the clinical implications of these findings, identifies gaps in the current evidence base, and suggests directions for future research. The synthesis of findings reveals that higher CRF levels (general threshold of > 7 METs) are consistently associated with a reduced risk of a range of cancers, including head and neck, lung, breast, gastrointestinal, particularly pancreatic and colorectal, bladder, overall cancer incidence and mortality, and potentially stomach and liver, bile duct, and gall bladder cancers. These inverse associations between CRF and cancer risk do not generally differ across age groups, sex, race, or adiposity, suggesting a universal protective effect of CRF. Nonetheless, evidence linking CRF with skin, mouth and pharynx, kidney, and endometrial cancers is limited and inconclusive. Conversely, higher CRF levels may be potentially linked to an increased risk of prostate cancer and hematological malignancies, such as leukemia and myeloma, although the evidence is still not conclusive. CRF appears to play a significant role in reducing the risk of several cancers through various biological mechanisms, including inflammation reduction, immune system enhancement, hormonal regulation, and metabolic improvements. Overall, enhancing CRF through regular physical activity offers a vital, accessible strategy for reducing cancer risk and extending the health span. Future research should aim to fill the existing evidence gaps regarding specific cancers and elucidate the detailed dose-response relationships between CRF levels and cancer risk. Studies are also needed to elucidate the causal relationships and mechanistic pathways linking CRF to cancer outcomes.
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Affiliation(s)
- Setor K Kunutsor
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, LE5 4WP, UK.
| | - Leonard A Kaminsky
- Clinical Exercise Physiology, College of Health, Ball State University, Muncie, IN, USA
| | - Andrea Lehoczki
- Department of Public Health, Semmelweis University, Budapest, Hungary
- Doctoral College, Health Sciences Program, Semmelweis University, Budapest, Hungary
- Department of Haematology and Stem Cell Transplantation, National Institute for Haematology and Infectious Diseases, South Pest Central Hospital, 1097, Budapest, Hungary
| | - Jari A Laukkanen
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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Cai L, Gonzales T, Wheeler E, Kerrison ND, Day FR, Langenberg C, Perry JRB, Brage S, Wareham NJ. Causal associations between cardiorespiratory fitness and type 2 diabetes. Nat Commun 2023; 14:3904. [PMID: 37400433 DOI: 10.1038/s41467-023-38234-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 04/21/2023] [Indexed: 07/05/2023] Open
Abstract
Higher cardiorespiratory fitness is associated with lower risk of type 2 diabetes. However, the causality of this relationship and the biological mechanisms that underlie it are unclear. Here, we examine genetic determinants of cardiorespiratory fitness in 450k European-ancestry individuals in UK Biobank, by leveraging the genetic overlap between fitness measured by an exercise test and resting heart rate. We identified 160 fitness-associated loci which we validated in an independent cohort, the Fenland study. Gene-based analyses prioritised candidate genes, such as CACNA1C, SCN10A, MYH11 and MYH6, that are enriched in biological processes related to cardiac muscle development and muscle contractility. In a Mendelian Randomisation framework, we demonstrate that higher genetically predicted fitness is causally associated with lower risk of type 2 diabetes independent of adiposity. Integration with proteomic data identified N-terminal pro B-type natriuretic peptide, hepatocyte growth factor-like protein and sex hormone-binding globulin as potential mediators of this relationship. Collectively, our findings provide insights into the biological mechanisms underpinning cardiorespiratory fitness and highlight the importance of improving fitness for diabetes prevention.
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Affiliation(s)
- Lina Cai
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Tomas Gonzales
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Eleanor Wheeler
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Felix R Day
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - John R B Perry
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Gonzales TI, Jeon JY, Lindsay T, Westgate K, Perez-Pozuelo I, Hollidge S, Wijndaele K, Rennie K, Forouhi N, Griffin S, Wareham N, Brage S. Resting heart rate is a population-level biomarker of cardiorespiratory fitness: The Fenland Study. PLoS One 2023; 18:e0285272. [PMID: 37167327 PMCID: PMC10174582 DOI: 10.1371/journal.pone.0285272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 04/19/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Few large studies have evaluated the relationship between resting heart rate (RHR) and cardiorespiratory fitness. Here we examine cross-sectional and longitudinal relationships between RHR and fitness, explore factors that influence these relationships, and demonstrate the utility of RHR for remote population monitoring. METHODS In cross-sectional analyses (The UK Fenland Study: 5,722 women, 5,143 men, aged 29-65y), we measured RHR (beats per min, bpm) while seated, supine, and during sleep. Fitness was estimated as maximal oxygen consumption (ml⋅min-1⋅kg-1) from an exercise test. Associations between RHR and fitness were evaluated while adjusting for age, sex, adiposity, and physical activity. In longitudinal analyses (6,589 participant subsample), we re-assessed RHR and fitness after a median of 6 years and evaluated the association between within-person change in RHR and fitness. During the coronavirus disease-2019 pandemic, we used a smartphone application to remotely and serially measure RHR (1,914 participant subsample, August 2020 to April 2021) and examined differences in RHR dynamics by pre-pandemic fitness level. RESULTS Mean RHR while seated, supine, and during sleep was 67, 64, and 57 bpm. Age-adjusted associations (beta coefficients) between RHR and fitness were -0.26, -0.29, and -0.21 ml⋅kg-1⋅beat-1 in women and -0.27, -0.31, and -0.19 ml⋅kg-1⋅beat-1 in men. Adjustment for adiposity and physical activity attenuated the RHR-to-fitness relationship by 10% and 50%, respectively. Longitudinally, a 1-bpm increase in supine RHR was associated with a 0.23 ml⋅min-1⋅kg-1 decrease in fitness. During the pandemic, RHR increased in those with low pre-pandemic fitness but was stable in others. CONCLUSIONS RHR is a valid population-level biomarker of cardiorespiratory fitness. Physical activity and adiposity attenuate the relationship between RHR and fitness.
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Affiliation(s)
- Tomas I. Gonzales
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Justin Y. Jeon
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients (ICONS), Yonsei University, Seoul, Korea
| | - Timothy Lindsay
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Stefanie Hollidge
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kirsten Rennie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nita Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Simon Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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No Effect of Calanus Oil on Maximal Oxygen Uptake in Healthy Participants: A Randomized Controlled Study. Int J Sport Nutr Exerc Metab 2022; 32:468-478. [PMID: 35998897 DOI: 10.1123/ijsnem.2022-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022]
Abstract
We aimed to investigate the long-term effect of daily Calanus oil supplementation on maximal oxygen uptake (VO2max) in healthy 30- to 50-year-old participants. The study was motivated by preclinical studies reporting increased VO2max and metabolic health with omega-3 rich Calanus oil. In a double-blinded study, 71 participants were randomized to receive 2 g/day of Calanus or placebo supplementation for a total of 6 months. The participants underwent exercise testing and clinical investigations at baseline, 3 months, and 6 months. Main study endpoint was change in VO2max from baseline to 6 months. Fifty-eight participants completed the 6-month test and were included in the final data analysis (age: Calanus, 39.7 [38.0, 41.4] and placebo, 38.8 [36.8, 40.9] years; body mass index: Calanus, 24.8 [24.0, 25.6] and placebo, 24.8 [23.7, 25.8] kg/m2; and VO2max: Calanus, 50.4 [47.1, 53.8] and placebo, 50.2 [47.2, 53.1] ml·kg-1·min-1). There were no between-group differences at baseline, nor were there any between-group differences in absolute (Calanus, 3.74 [3.44, 4.04] and placebo, 3.79 [3.44, 4.14] L/min) or relative VO2max (Calanus, 49.7 [46.2, 53.2] and placebo, 49.5 [46.0, 53.1] ml·kg-1·min-1) at 6 months (mean [95% confidence interval]). There were no between-groups change in clinical measures from baseline to 3 and 6 months. In conclusion, VO2max was unaffected by 6 months of daily Calanus oil supplementation in healthy, physically fit, normal to overweight men and women between 30 and 50 years old.
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Park DH, Cho W, Lee YH, Jee SH, Jeon JY. The predicting value of resting heart rate to identify undiagnosed diabetes in Korean adult: Korea National Health and Nutrition Examination Survey. Epidemiol Health 2022; 44:e2022009. [PMID: 34990528 PMCID: PMC9117096 DOI: 10.4178/epih.e2022009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/27/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The purpose of this study was (1) to examine whether the addition of resting heart rate (RHR) to the existing undiagnosed diabetes mellitus (UnDM) prediction model would improve predictability, and (2) to develop and validate UnDM prediction models by using only easily assessable variables such as gender, RHR, age, and waist circumference (WC). METHODS Korea National Health and Nutrition Examination Survey (KNHANES) 2010, 2012, 2014, 2016 data were used to develop the model (model building set, n=19,675), while the data from 2011, 2013, 2015, 2017 were used to validate the model (validation set, n=19,917). UnDM was defined as a fasting glucose level ≥126 mg/dL or glycated hemoglobin ≥6.5%; however, doctors have not diagnosed it. Statistical package for the social sciences logistic regression analysis was used to determine the predictors of UnDM. RESULTS RHR, age, and WC were associated with UnDM. When RHR was added to the existing model, sensitivity was reduced (86 vs. 73%), specificity was increased (49 vs. 65%), and a higher Youden index (35 vs. 38) was expressed. When only gender, RHR, age, and WC were used in the model, a sensitivity, specificity, and Youden index of 70%, 67%, and 37, respectively, were observed. CONCLUSIONS Adding RHR to the existing UnDM prediction model improved specificity and the Youden index. Furthermore, when the prediction model only used gender, RHR, age, and WC, the outcomes were not inferior to those of the existing prediction model.
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Affiliation(s)
- Dong-Hyuk Park
- Department of Sports industry, Yonsei University, Seoul , Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Seoul, Korea
| | - Wonhee Cho
- Department of Sports industry, Yonsei University, Seoul , Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Justin Y Jeon
- Department of Sports industry, Yonsei University, Seoul , Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Seoul, Korea
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Gutierrez-Martinez L, Brellenthin AG, Lefferts EC, Lee DC, Sui X, Lavie CJ, Blair SN. Resting Heart Rate and Risk of Cancer Mortality. Cancer Epidemiol Biomarkers Prev 2021; 30:1072-1078. [PMID: 33827985 PMCID: PMC8172441 DOI: 10.1158/1055-9965.epi-20-1731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/16/2021] [Accepted: 03/26/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Increased resting heart rate (RHR) is a predictor of mortality. RHR is influenced by cardiorespiratory fitness (CRF). Little is known about the combined associations of RHR and CRF on cancer mortality. METHODS 50,108 men and women (mean age 43.8 years) were examined between 1974 and 2002 at the Cooper Clinic in Dallas, Texas. RHR was measured by electrocardiogram and categorized as <60, 60-69, 70-79, or ≥80 beats/minute. CRF was quantified by maximal treadmill test and dichotomized as unfit and fit corresponding to the lower 20% and the upper 80%, respectively, of the age- and sex-specific distribution of treadmill exercise duration. The National Death Index was used to ascertain vital status. Cox regression was used to compute HRs and 95% confidence intervals (CI) for cancer mortality across RHR categories. RESULTS During a mean follow-up of 15.0 ± 8.6 years, 1,090 cancer deaths occurred. Compared with RHR <60 beats/minute, individuals with RHR ≥80 beats/minute had a 35% increased risk of overall cancer mortality (HR, 1.35; 95% CI, 1.06-1.71) after adjusting for confounders, including CRF. Compared with "fit and RHR <80 beats/minute", HRs (95% CI) for cancer mortality were 1.41 (1.20-1.66), 1.51 (1.11-2.04), and 1.78 (1.30-2.43) in "unfit and RHR <80," "fit and RHR ≥80," and "unfit and RHR ≥80 beats/minute," respectively. CONCLUSIONS RHR ≥80 beats/minute is associated with an increased risk of overall cancer mortality. High CRF may help lower the risk of cancer mortality among those with high RHR. IMPACT RHR along with CRF may provide informative data about an individual's cancer mortality risk.
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Affiliation(s)
| | | | | | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, Iowa
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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Pendergrast LA, Leszczynski EC, Visker JR, Triplett AN, Ferguson DP. Early life undernutrition reduces maximum treadmill running capacity in adulthood in mice. Appl Physiol Nutr Metab 2020; 45:240-250. [DOI: 10.1139/apnm-2019-0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Undernutrition during early life causes chronic disease with specific impairments to the heart and skeletal muscle. The purpose of this study was to determine the effects of early life undernutrition on adult exercise capacity as a result of cardiac and skeletal muscle function. Pups were undernourished during gestation (GUN) or lactation (PUN) using a cross-fostering nutritive mouse model. At postnatal day 21, all mice were weaned and refed a control diet. At postnatal day 67, mice performed a maximal treadmill test. Echocardiography and Doppler blood flow analysis was performed at postnatal day 72, following which skeletal muscle cross-sectional area (CSA) and fiber type were determined. Maximal running capacity was reduced (diet: P = 0.0002) in GUN and PUN mice. Left ventricular mass (diet: P = 0.03) and posterior wall thickness during systole (diet × sex: P = 0.03) of GUN and PUN mice was reduced, causing PUN mice to have reduced (diet: P = 0.04) stroke volume. Heart rate of GUN mice showed a trend (diet: P = 0.07) towards greater resting values than other groups. PUN mice had greater CSA of soleus fibers. PUN had a reduced (diet: P = 0.03) proportion of type-IIX fibers in the extensor digitorum longus (EDL) and a greater (diet: P = 0.008) percentage of type-IIB fibers in the EDL. In conclusion, gestational and postnatal undernourishment impairs exercise capacity.
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Affiliation(s)
- Logan A. Pendergrast
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
| | - Eric C. Leszczynski
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
| | - Joseph R. Visker
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
| | - Ashley N. Triplett
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
| | - David P. Ferguson
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
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Dun Y, Smith JR, Liu S, Olson TP. High-Intensity Interval Training in Cardiac Rehabilitation. Clin Geriatr Med 2019; 35:469-487. [PMID: 31543179 DOI: 10.1016/j.cger.2019.07.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Recently, high-intensity interval training (HIIT) has been recognized as a safe and effective alternative to moderate-intensity continuous training for older patients with cardiovascular disease (CVD) in cardiac rehabilitation settings in an effort to improve health outcomes. This brief review considers general principles and suggestions for prescription of HIIT for older patients with CVD, specific challenges pertaining to older adults, the physiologic mechanisms by which HIIT contributes to improvements in peak Vo2, and the effects of HIIT on cardiovascular health in older patients with coronary artery disease and heart failure.
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Affiliation(s)
- Yaoshan Dun
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital Central South University, 87 Xiangya Road, Changsha, Hunan, P.R. China; Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Joshua R Smith
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Suixin Liu
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital Central South University, 87 Xiangya Road, Changsha, Hunan, P.R. China.
| | - Thomas P Olson
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
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An SJ, Jung MH, Ihm SH, Yang YJ, Youn HJ. Effect of physical activity on the cardiometabolic profiles of non-obese and obese subjects: Results from the Korea National Health and Nutritional Examination Survey. PLoS One 2019; 14:e0208189. [PMID: 30822340 PMCID: PMC6396903 DOI: 10.1371/journal.pone.0208189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 11/13/2018] [Indexed: 11/21/2022] Open
Abstract
Background Physical inactivity is an important but often neglected risk factor for various cardiovascular diseases. We hypothesized that physical inactivity might have deleterious effects on metabolic health in obese and non-obese subjects. Methods We evaluated the effect of physical activity on the cardiometabolic profiles of a nationwide cohort of non-obese and obese individuals who did not have overt cardiovascular diseases. A total of 3,830 study subjects were divided into two groups based on their body mass index (BMI). Within each BMI group, participants were divided according to their physical activity level. To ascertain their cardiometabolic profiles, we collected data regarding the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, high-density lipoprotein (HDL)-cholesterol level, systolic blood pressure, heart rate, and high-sensitivity C-reactive protein (hsCRP) level. Results Physically inactive subjects demonstrated markedly elevated HOMA-IR index and heart rates in each BMI category, even after adjustments for baseline covariates. They also tended to have worse profiles for HDL-cholesterol, systolic blood pressure, and hsCRP levels. A significant elevation in cardiometabolic risk was noted across the four physical activity/obesity groups (p<0.05). HOMA-IR index was largely affected by obesity, but within each BMI category, physical inactivity independently elevated the risk for worsening insulin resistance. In addition, physical inactivity significantly increased the risk of elevated heart rate in both non-obese and obese individuals. Notably, the detrimental effect of physical activity on heart rate was not modified by obesity. Conclusions Physical activity was associated with favorable cardiometabolic risk profiles with regard to insulin resistance status and heart rate level in both BMI groups. Our results suggest that increasing physical activity could be a helpful strategy for improving the cardiometabolic health in the Korean population, regardless of obesity status.
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Affiliation(s)
- Sang Joon An
- Department of Neurology, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Mi-Hyang Jung
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
- * E-mail:
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yun-jung Yang
- Institute of Biomedical Science, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Dereppe H, Verbeke M, Debruxelles C, Boucq E, Ponzoni L, Cuvelier G. Energy expenditure of household activities and cardiorespiratory fitness in women with obesity. Clin Obes 2018; 8:391-397. [PMID: 30231189 DOI: 10.1111/cob.12276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/27/2018] [Accepted: 07/10/2018] [Indexed: 01/22/2023]
Affiliation(s)
- H Dereppe
- Service de Cardiologie, CHWAPI - Centre d'Orthonutrition, Tournai, Belgium
| | - M Verbeke
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - C Debruxelles
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - E Boucq
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - L Ponzoni
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - G Cuvelier
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
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Jung MH, Youn HJ, Ihm SH, Jung HO, Hong KS. Heart Rate and Bone Mineral Density in Older Women with Hypertension: Results from the Korea National Health and Nutritional Examination Survey. J Am Geriatr Soc 2018; 66:1144-1150. [PMID: 29608214 DOI: 10.1111/jgs.15359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To determine whether high heart rate is associated with low bone mineral density (BMD) in older women with hypertension. DESIGN Retrospective cohort study. SETTING Population-based study conducted in Korea (Korea National Health and Nutritional Examination Survey 2009-10). PARTICIPANTS Postmenopausal women aged 60 and older with hypertension (N=981) divided into 2 groups according to resting heart rate, with a cut-off value of 80 bpm, which has been found to be associated with osteoporosis. MEASUREMENTS BMD profiles and clinical and laboratory data were collected. Osteoporosis was defined as a T-score of -2.5 or less, according to World Health Organization criteria. RESULTS BMD was significantly lower in participants with a high heart rate, even after adjustment for age, diabetes mellitus, white blood cell count, and fasting glucose and triglyceride levels. The prevalence of osteoporosis was also significantly higher in those participants. In multivariate logistic regression analysis, the group with high heart rate was 1.7 times as likely (95% confidence interval=1.2-2.3) to have osteoporosis as those with a lower heart rate, independent of age, body mass index, comorbidities, and laboratory findings. CONCLUSION High heart rate is independently associated with lower BMD in older women with hypertension; proactive surveillance of BMD could be helpful when managing older women with hypertension and a high heart rate.
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Affiliation(s)
- Mi-Hyang Jung
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hae Ok Jung
- Division of Cardiology, Department of Internal Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Soon Hong
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Abbott T, Minto G, Lee A, Pearse R, Ackland G. Elevated preoperative heart rate is associated with cardiopulmonary and autonomic impairment in high-risk surgical patients. Br J Anaesth 2017; 119:87-94. [DOI: 10.1093/bja/aex164] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 02/05/2023] Open
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14
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Kang SJ, Ha GC, Ko KJ. Association between resting heart rate, metabolic syndrome and cardiorespiratory fitness in Korean male adults. J Exerc Sci Fit 2017; 15:27-31. [PMID: 29541128 PMCID: PMC5812868 DOI: 10.1016/j.jesf.2017.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/02/2017] [Accepted: 06/08/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND/OBJECTIVE The present study aimed to investigate the association between metabolic syndrome and cardiorespiratory fitness according to resting heart rate of Korean male adults. METHODS A total of 11,876 male adults aged 20-65 years who underwent health examinations from 2010 to 2015 at a National Fitness Centre in South Korea were included. Subjects' resting heart rate, cardiorespiratory fitness (VO2max), and metabolic syndrome parameters were collected. The subjects were divided into 5 categories (<60 bpm, 60-69 bpm, 70-79 bpm, 80-89 bpm, and ≥90 bpm) of resting heart rate for further analysis. RESULTS We found that elevated resting heart rate was positively associated with body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, and fasting blood glucose levels (p < 0.001, respectively); in contrast, elevated resting heart rate was inversely associated with VO2max (p < 0.001). When resting heart rate of subjects was categorized into quintiles and analysed, the results showed that the relative risk of metabolic syndrome was 1.53-fold higher (95% CI, 1.34 to 1.82) in the range of 60-69 beats per minute (bpm), 2.08-fold higher (95% CI, 1.77 to 2.45) in the range of 70-79 bpm, 2.28-fold higher (95% CI, 1.73 to 3.00) in the range of 80-89 bpm, and 2.61-fold higher (95% CI, 1.62 to 4.20) in the range of ≥90 bpm, compared to those <60 bpm; this indicated that as resting heart rate increased, the relative risk of metabolic syndrome also increased. CONCLUSION Resting heart rate of male adults was found to be associated with cardiorespiratory fitness; the risk factors for metabolic syndrome and relative risk of metabolic syndrome increased as resting heart rate increased.
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Affiliation(s)
- Seol-Jung Kang
- Department of Physical Education, Changwon National University, Republic of Korea
| | - Gi-Chul Ha
- Department of Sports Medicine, National Health Fitness Center, Republic of Korea
| | - Kwang-Jun Ko
- Department of Sports Medicine, National Health Fitness Center, Republic of Korea
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Jung MH, Ihm SH, Lee DH, Chung WB, Jung HO, Youn HJ. Prehypertension is associated with early complications of atherosclerosis but not with exercise capacity. Int J Cardiol 2017; 227:387-392. [DOI: 10.1016/j.ijcard.2016.11.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 08/21/2016] [Accepted: 11/05/2016] [Indexed: 11/30/2022]
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16
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Korshøj M, Lidegaard M, Krustrup P, Jørgensen MB, Søgaard K, Holtermann A. Long Term Effects on Risk Factors for Cardiovascular Disease after 12-Months of Aerobic Exercise Intervention - A Worksite RCT among Cleaners. PLoS One 2016; 11:e0158547. [PMID: 27513932 PMCID: PMC4981369 DOI: 10.1371/journal.pone.0158547] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 06/18/2016] [Indexed: 01/09/2023] Open
Abstract
Objectives Occupational groups exposed to high occupational physical activity have an increased risk for cardiovascular disease (CVD). This may be explained by the high relative aerobic workload. Enhanced cardiorespiratory fitness reduces the relative aerobic workload. Thus, the aim was to evaluate the 12-months effects of worksite aerobic exercise on risk factors for CVD among cleaners. Methods One hundred and sixteen cleaners aged 18–65 years were randomized to a group performing aerobic exercise and a reference group receiving lectures. Outcomes were collected at baseline and after 12-months. A repeated measures 2×2 multi-adjusted mixed-model design was applied to compare the between-group differences using intention-to-treat analysis. Results Between-group differences (p<0.05) were found favouring the aerobic exercise group: cardiorespiratory fitness 2.15 (SE 1.03) mlO2/min/kg, aerobic workload -2.15 (SE 1.06) %HRR, resting HR -5.31 (SE 1.61) beats/min, high sensitive C-reactive protein -0.65 (SE 0.24) μg/ml. The blood pressure was unaltered. Stratified analyses on relative aerobic workload at baseline revealed that those with relative aerobic workloads ≥30% of HRR seems to impose a notable adverse effect on resting and ambulatory blood pressure. Conclusion This long-term worksite aerobic exercise intervention among cleaners led to several beneficial effects, but also potential adverse effects among those with high relative aerobic workloads. Trial Registration Controlled-Trials.com ISRCTN86682076
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark
- * E-mail:
| | - Mark Lidegaard
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark
- Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke's Campus, University of Exeter, Exeter, United Kingdom
| | - Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Kato Y, Suzuki S, Uejima T, Semba H, Nagayama O, Hayama E, Yamashita T. The relationship between resting heart rate and peak VO2: A comparison of atrial fibrillation and sinus rhythm. Eur J Prev Cardiol 2016; 23:1429-36. [DOI: 10.1177/2047487316633885] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 01/30/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Yuko Kato
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Japan
| | - Shinya Suzuki
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Japan
| | - Tokuhisa Uejima
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Japan
| | - Hiroaki Semba
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Japan
| | - Osamu Nagayama
- Department of Clinical laboratory, The Cardiovascular Institute, Japan
| | - Etsuko Hayama
- Department of Clinical laboratory, The Cardiovascular Institute, Japan
| | - Takeshi Yamashita
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Japan
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Spartano NL, Lyass A, Larson MG, Lewis GD, Vasan RS. Submaximal Exercise Systolic Blood Pressure and Heart Rate at 20 Years of Follow-up: Correlates in the Framingham Heart Study. J Am Heart Assoc 2016; 5:e002821. [PMID: 27233297 PMCID: PMC4937245 DOI: 10.1161/jaha.115.002821] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/19/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Beyond their resting values, exercise responses in blood pressure (BP) and heart rate (HR) may add prognostic information for cardiovascular disease (CVD). In cross-sectional studies, exercise BP and HR responses correlate with CVD risk factors; however, it is unclear which factors influence longitudinal changes in exercise responses over time, which is important for our understanding of the development of CVD. METHODS AND RESULTS We assessed BP and HR responses to low-level exercise tests (6-minute Bruce protocol) in 1231 Framingham Offspring participants (55% women) who underwent a routine treadmill test in 1979-1983 (baseline; mean age 39±8 years) that was repeated in 1998-2001 (follow-up; mean age 58±8 years). Adjusting for baseline exercise responses, we related the follow-up exercise responses to baseline CVD risk factors and to their changes between examinations. Compared with men, women had greater rise in exercise systolic (S)BP and HR at 20-year follow-up (both P<0.005). Baseline blood lipid levels, resting SBP and HR, and smoking status were associated with greater exercise SBP at follow-up (all P<0.05). Weight gain across examinations was associated with higher exercise SBP and HR at follow-up (both P<0.0001). Smoking cessation was associated with a 53% reduced risk of attaining the highest quartile of exercise SBP (≥180 mm Hg) at follow-up (P<0.05). CONCLUSION An adverse CVD risk factor profile in young adults and its worsening over time were associated with higher SBP and HR responses to low-level exercise in midlife. Maintaining or adopting a healthy risk factor profile may favorably impact the exercise responses over time.
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Affiliation(s)
- Nicole L Spartano
- Sections of Preventative Medicine and Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | - Asya Lyass
- Framingham Heart Study, Framingham, MA Department of Mathematics and Statistics, Boston University, Boston, MA
| | - Martin G Larson
- Framingham Heart Study, Framingham, MA Department of Mathematics and Statistics, Boston University, Boston, MA Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Gregory D Lewis
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Cambridge, MA Pulmonary and Critical Care Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA Broad Institute of MIT and Harvard, Cambridge, MA
| | - Ramachandran S Vasan
- Sections of Preventative Medicine and Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA Framingham Heart Study, Framingham, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA
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19
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Spartano NL, Himali JJ, Beiser AS, Lewis GD, DeCarli C, Vasan RS, Seshadri S. Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later. Neurology 2016; 86:1313-1319. [PMID: 26865519 DOI: 10.1212/wnl.0000000000002415] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/14/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether poor cardiovascular (CV) fitness and exaggerated exercise blood pressure (BP) and heart rate (HR) were associated with worse brain morphology in later life. METHODS Framingham Offspring participants (n = 1,094, 53.9% female) free from dementia and CV disease (CVD) underwent an exercise treadmill test at a mean age of 40 ± 9 years. A second treadmill test and MRI scans of the brain were administered 2 decades later at mean age of 58 ± 8 years. RESULTS Poor CV fitness and greater diastolic BP and HR response to exercise at baseline were associated with a smaller total cerebral brain volume (TCBV) almost 2 decades later (all p < 0.05) in multivariable adjusted models; the effect of 1 SD lower fitness was equivalent to approximately 1 additional year of brain aging in individuals free of CVD. In participants with prehypertension or hypertension at baseline, exercise systolic BP was also associated with smaller TCBV (p < 0.05). CONCLUSION Our results suggest that lower CV fitness and exaggerated exercise BP and HR responses in middle-aged adults are associated with smaller brain volume nearly 2 decades later. Promotion of midlife CV fitness may be an important step towards ensuring healthy brain aging.
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Affiliation(s)
- Nicole L Spartano
- From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis.
| | - Jayandra J Himali
- From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis
| | - Alexa S Beiser
- From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis
| | - Gregory D Lewis
- From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis
| | - Charles DeCarli
- From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis
| | - Ramachandran S Vasan
- From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis
| | - Sudha Seshadri
- From the Section of Preventive Medicine and Epidemiology (N.L.S., R.S.V.), The Whitaker Cardiovascular Institute (N.L.S.), and Department of Neurology (J.J.H., A.S.B., S.S.), Boston University School of Medicine; the Framingham Heart Study (N.L.S., J.J.H., A.S.B., R.S.V., S.S.); Departments of Biostatistics (A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health; Cardiology Division (G.D.L.) and the Pulmonary and Critical Care Unit (G.D.L.), Massachusetts General Hospital, Harvard Medical School; Broad Institute of MIT & Harvard (G.D.L.), Cambridge, MA; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis
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Kato Y, Suzuki S, Kano H, Semba H, Matsuno S, Takai H, Otsuka T, Uejima T, Oikawa Y, Nagashima K, Kirigaya H, Sagara K, Kunihara T, Yajima J, Sawada H, Aizawa T, Yamashita T. Prognostic significance of exercise capacity and resting heart rate: Comparison between atrial fibrillation and sinus rhythm. Int J Cardiol 2016; 203:561-3. [DOI: 10.1016/j.ijcard.2015.10.227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/26/2022]
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Aladin AI, Whelton SP, Al-Mallah MH, Blaha MJ, Keteyian SJ, Juraschek SP, Rubin J, Brawner CA, Michos ED. Relation of resting heart rate to risk for all-cause mortality by gender after considering exercise capacity (the Henry Ford exercise testing project). Am J Cardiol 2014; 114:1701-6. [PMID: 25439450 DOI: 10.1016/j.amjcard.2014.08.042] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/26/2014] [Accepted: 08/26/2014] [Indexed: 11/22/2022]
Abstract
Whether resting heart rate (RHR) predicts mortality independent of fitness is not well established, particularly among women. We analyzed data from 56,634 subjects (49% women) without known coronary artery disease or atrial fibrillation who underwent a clinically indicated exercise stress test. Baseline RHR was divided into 5 groups with <60 beats/min as reference. The Social Security Death Index was used to ascertain vital status. Cox hazard models were performed to determine the association of RHR with all-cause mortality, major adverse cardiovascular events, myocardial infarction, or revascularization after sequential adjustment for demographics, cardiovascular disease risk factors, medications, and fitness (metabolic equivalents). The mean age was 53 ± 12 years and mean RHR was 73 ± 12 beats/min. More than half of the participants were referred for chest pain; 81% completed an adequate stress test and mean metabolic equivalents achieved was 9.2 ± 3. There were 6,255 deaths over 11.0-year mean follow-up. There was an increased risk of all-cause mortality with increasing RHR (p trend <0.001). Compared with the lowest RHR group, participants with an RHR ≥90 beats/min had a significantly increased risk of mortality even after adjustment for fitness (hazard ratio 1.22, 95% confidence interval 1.10 to 1.35). This relationship remained significant for men, but not significant for women after adjustment for fitness (p interaction <0.001). No significant associations were seen for men or women with major adverse cardiovascular events, myocardial infarction, or revascularization after accounting for fitness. In conclusion, after adjustment for fitness, elevated RHR was an independent risk factor for all-cause mortality in men but not women, suggesting gender differences in the utility of RHR for risk stratification.
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Affiliation(s)
- Amer I Aladin
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Seamus P Whelton
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mouaz H Al-Mallah
- Division of Cardiovascular Medicine, Henry Ford Health System, Detroit, Michigan; King Abdulaziz Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Steven J Keteyian
- Division of Cardiovascular Medicine, Henry Ford Health System, Detroit, Michigan
| | - Stephen P Juraschek
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jonathan Rubin
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Clinton A Brawner
- Division of Cardiovascular Medicine, Henry Ford Health System, Detroit, Michigan
| | - Erin D Michos
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland.
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Saxena A, Minton D, Lee DC, Sui X, Fayad R, Lavie CJ, Blair SN. Protective role of resting heart rate on all-cause and cardiovascular disease mortality. Mayo Clin Proc 2013; 88:1420-6. [PMID: 24290115 PMCID: PMC3908776 DOI: 10.1016/j.mayocp.2013.09.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/22/2013] [Accepted: 09/23/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To study the protective role of lower resting heart rate (RHR) in cardiovascular disease (CVD) and all-cause mortality. PATIENTS AND METHODS Patients (n=53,322) who received a baseline medical examination between January 1, 1974, and December 31, 2002, were recruited from the Cooper Clinic, Dallas, Texas. They completed a medical questionnaire and underwent clinical evaluation. Patients with CVD or cancer or who had less than 1 year of mortality follow-up were excluded from the study. Relative risks and 95% CIs for all-cause and CVD mortality across RHR categories were estimated using Cox proportional hazards models. RESULTS Highest cardiorespiratory fitness with lower mortality was found in individuals with an RHR of less than 60 beats/min. Similarly, patients with a higher RHR (≥80 beats/min) were at greater risk for CVD and all-cause mortality compared with an RHR of less than 60 beats/min. This analysis was followed by stratification of the data by hypertension, where hypertensive individuals with high RHRs (≥80 beats/min) were found to be at greater risk for CVD and all-cause mortality compared with those with hypertension and lower RHRs (<60 beats/min). In addition, unfit individuals with high RHRs had the greatest risk of CVD and all-cause mortality. The unfit with low RHR group had a similar risk for CVD and all-cause mortality as the fit with high RHR group. CONCLUSION Lower cardiorespiratory fitness levels and higher RHRs are linked to greater CVD and all-cause mortality.
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Affiliation(s)
- Arpit Saxena
- Department of Exercise Science, University of South Carolina, Columbia
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Campos JC, Gomes KMS, Ferreira JCB. Impact of exercise training on redox signaling in cardiovascular diseases. Food Chem Toxicol 2013; 62:107-19. [PMID: 23978413 DOI: 10.1016/j.fct.2013.08.035] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 08/05/2013] [Accepted: 08/18/2013] [Indexed: 02/07/2023]
Abstract
Reactive oxygen and nitrogen species regulate a wide array of signaling pathways that governs cardiovascular physiology. However, oxidant stress resulting from disrupted redox signaling has an adverse impact on the pathogenesis and progression of cardiovascular diseases. In this review, we address how redox signaling and oxidant stress affect the pathophysiology of cardiovascular diseases such as ischemia-reperfusion injury, hypertension and heart failure. We also summarize the benefits of exercise training in tackling the hyperactivation of cellular oxidases and mitochondrial dysfunction seen in cardiovascular diseases.
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Affiliation(s)
- Juliane C Campos
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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