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Luo P, Wu R, Gao W, Yan W, Wang R, Ye Y. Effects of high-intensity interval exercise on arterial stiffness in individuals at risk for cardiovascular disease: a meta-analysis. Front Cardiovasc Med 2024; 11:1376861. [PMID: 38694567 PMCID: PMC11061535 DOI: 10.3389/fcvm.2024.1376861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/04/2024] [Indexed: 05/04/2024] Open
Abstract
Objective The purpose of this meta-analysis was to investigate the effect of high-intensity interval training (HIIT) on arterial stiffness (AS) and vascular function in persons at high risk of cardiovascular disease (CVD). Methods We conducted a comprehensive search of randomized controlled trials (RCTs) published in electronic databases (PubMed, Web of Science, Cochrane, Embase, and Ebsco) since their inception through October 2023 to evaluate the effect of HIIT on AS and vascular function in persons at high risk for CVD. The weighted mean difference (WMD) and 95% confidence intervals (95% CI) were calculated, and heterogeneity was assessed using the I2 test. Results This study included 661 participants from 16 studies. HIIT significantly reduced pulse wave velocity (PWV) in persons at high risk for CVD [weighted mean difference (WMD), -0.62; 95% CI, -0.86--0.38; P < 0.00001]. Subgroup analysis showed that the PWV improvement effect was better when the HIIT program was performed 2-3 times per week and the duration was controlled within 40 min [2-3 times, -0.67; 95% CI, -0.93--0.41; P < 0.00001; time of duration, ≤40 min, -0.66; 95% CI, -0.91--0.41; P < 0.00001]. HIIT significantly reduced systolic blood pressure (SBP, -5.43; 95% CI, -8.82--2.04; P = 0.002), diastolic blood pressure (DPB, -2.96; 95% CI, -4.88--1.04; P = 0.002), and resting heart rate (RHR, -4.35; 95% CI, -7.04--1.66; P = 0.002), but had no significant effect on augmentation index (AIX, -2.14; 95% CI, -6.77-2.50; P = 0.37). Conclusion HIIT can improve PWV in high-risk individuals with CVD and reduce SBP, DBP, and RHR, but has no significant effect on AIX. HIIT can effectively improve AS and vascular function and can be recommended as an effective method to improve AS in high-risk persons with CVD. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42023471593.
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Affiliation(s)
- Ping Luo
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Ruoshan Wu
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Weifeng Gao
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Weiyi Yan
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Ruixue Wang
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Yufang Ye
- School of Physical Education, Wuhan Sport University, Wuhan, China
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Hill H, Elliot CA, Lizamore CA, Hamlin MJ. Physical activity has a stronger correlation with arterial stiffness than strength, balance, or BMI in an older population. FRONTIERS IN AGING 2023; 4:1279479. [PMID: 38162458 PMCID: PMC10755870 DOI: 10.3389/fragi.2023.1279479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
Background: Arterial stiffness is associated with an array of debilitating health conditions. While exercise typically has beneficial effects on both arterial stiffness and overall health, more research is needed to understand the associations of different types of fitness indices with arterial stiffness. Aim: To investigate the relationship between balance, strength, cardiovascular fitness and physical activity with arterial stiffness (as measured by pulse wave velocity (PWV)) in older adults. Method: Eighty retirement-village residents (24 males, 56 females, age: 78.2 ± 6.4 years, weight: 69.4 ± 12.5 kg, height: 162.9 ± 8.5 cm) completed the Yale Physical Activity Survey, PWV measurement, 30-s sit-to-stand leg strength test, hand grip strength assessment, 4-stage balance test, and a 6-min walk fitness test. The number of exiting risk factors (smoking, previous heart incidents, previous stroke(s), having hypertension, or taking anti-hypertension medication) were tallied. Pearson's correlations were used to assess the relationship between PWV and health and fitness parameters. Results were interpreted using qualitative inference. Results: The number of risk factors (r = 0.57, p < 0.001), age (r = 0.51, p < 0.001) and systolic blood pressure (r = 0.50, p = 0.001) had strong, harmful associations with PWV. Total physical activity minutes/week (r = -0.31 p = 0.01), total energy expenditure Kcal/week (r = -0.30, p = 0.01), and the 6-min walk test (r = -0.29, p = 0.01) had a moderate, beneficial association with PWV, while sit-to-stand (r = -0.27, p = 0.02) and balance (r = -0.27, p = 0.01) had a weak, beneficial association with PWV. Hand grip strength (r = 0.02, p = 0.94) and body mass index (r = -0.04, p = 0.75) had no significant associations with PWV. Discussion: All measured fitness indices had beneficial associations with PWV. However, having more risk factors, increased age, and higher systolic blood pressure had significant (harmful) associations with PWV in our older population. Conclusion: Controlling cardiovascular risk factors, especially high systolic blood pressure, is likely to have the largest beneficial effect on PWV. Improving general physical activity, including walking capacity, may prove beneficial in improving PWV in an older population.
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Affiliation(s)
- Hannah Hill
- Department of Tourism, Sport, and Society, Lincoln University, Lincoln, New Zealand
| | - Catherine A. Elliot
- Department of Tourism, Sport, and Society, Lincoln University, Lincoln, New Zealand
| | - Catherine A. Lizamore
- Department of Applied Science and Social Practice, Ara Institute of Canterbury, Christchurch, New Zealand
| | - Michael J. Hamlin
- Department of Tourism, Sport, and Society, Lincoln University, Lincoln, New Zealand
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Bakali M, Ward TC, Daynes E, Jones AV, Hawthorne GM, Latimer L, Divall P, Graham-Brown M, McCann GP, Yates T, Steiner MC, Evans RA. Effect of aerobic exercise training on pulse wave velocity in adults with and without long-term conditions: a systematic review and meta-analysis. Open Heart 2023; 10:e002384. [PMID: 38101857 PMCID: PMC10729135 DOI: 10.1136/openhrt-2023-002384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/11/2023] [Indexed: 12/17/2023] Open
Abstract
RATIONALE There is conflicting evidence whether aerobic exercise training (AET) reduces pulse wave velocity (PWV) in adults with and without long-term conditions (LTCs). OBJECTIVE To explore whether PWV improves with AET in adults with and without LTC, to quantify the magnitude of any effect and understand the influence of the exercise prescription. DATA SOURCES CENTRAL, MEDLINE and EMBASE were among the databases searched. ELIGIBILITY CRITERIA We included studies with a PWV measurement before and after supervised AET of at least 3 weeks duration. Exclusion criteria included resistance exercise and alternative measures of arterial stiffness. DESIGN Controlled trials were included in a random effects meta-analysis to explore the effect of AET on PWV. Uncontrolled studies were included in a secondary meta-analysis and meta-regression exploring the effect of patient and programme factors on change in PWV. The relevant risk of bias tool was used for each study design. RESULTS 79 studies (n=3729) were included: 35 controlled studies (21 randomised control trials (RCT) (n=1240) and 12 non-RCT (n=463)) and 44 uncontrolled (n=2026). In the controlled meta- analysis, PWV was significantly reduced following AET (mean (SD) 11 (7) weeks) in adults with and without LTC (mean difference -0.63; 95% CI -0.82 to -0.44; p<0.0001). PWV was similarly reduced between adults with and without LTC (p<0.001). Age, but not specific programme factors, was inversely associated with a reduction in PWV -0.010 (-0.020 to -0.010) m/s, p<0.001. DISCUSSION Short-term AET similarly reduces PWV in adults with and without LTC. Whether this effect is sustained and the clinical implications require further investigation.
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Affiliation(s)
- Majda Bakali
- NIHR Leicester Biomedical Research Centre -Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Thomas Cj Ward
- NIHR Leicester Biomedical Research Centre -Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Enya Daynes
- Centre of Exercise and Reshabilitaiton Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Amy V Jones
- Centre of Exercise and Reshabilitaiton Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Grace M Hawthorne
- Centre of Exercise and Reshabilitaiton Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Lorna Latimer
- NIHR Leicester Biomedical Research Centre -Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- Centre of Exercise and Reshabilitaiton Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Pip Divall
- Education Centre Library, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Matt Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Michael C Steiner
- NIHR Leicester Biomedical Research Centre -Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Rachael Andrea Evans
- NIHR Leicester Biomedical Research Centre -Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- Centre of Exercise and Reshabilitaiton Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
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Li P, Liu Z, Wan K, Wang K, Zheng C, Huang J. Effects of regular aerobic exercise on vascular function in overweight or obese older adults: A systematic review and meta-analysis. J Exerc Sci Fit 2023; 21:313-325. [PMID: 37520931 PMCID: PMC10372915 DOI: 10.1016/j.jesf.2023.06.002] [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: 01/22/2023] [Revised: 04/16/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023] Open
Abstract
Background Overweight and obese older adults have a high risk for developing cardiovascular disease. Aerobic exercise is a valuable strategy to improve vascular health, but the effects of aerobic exercise on vascular endothelial function in obese and overweight older adults remain controversial. The purpose of this meta-analysis was to investigate the effects of aerobic exercise on vascular function in obese and overweight older adults with or without comorbidity. Methods A systematic literature search for related studies published in English was conducted between January 1989 and October 30, 2022, in the PubMed, Embase, and Cochrane Library databases. A random effects model was chosen for meta-analysis, which calculated the effect sizes of control and intervention groups after exercise intervention using standardized mean differences (SMDs) corrected for Hedges' g bias and 95% confidence intervals (95% CIs). Results Twenty-six studies containing 1418 participants were included in the study. After excluding three studies contributing to higher heterogeneity by sensitivity analysis, there are small effects of regular aerobic exercise on vascular function of obese and overweight older adults, including flow-mediated dilation (FMD) [SMD = 0.21, 95% CI (0.02, 0.41), z = 2.16, df = 19, I2 = 52.2%, P = 0.031] and pulse wave velocity (PWV) [SMD = -0.24, 95% CI (-0.46, -0.02), z = 2.17, df = 10, I2 = 8.6%, P = 0.030], and no significant effect was observed on augmentation index (Aix). Subgroup analysis showed small effects of regular aerobic exercise on FMD [SMD = 0.37, 95% CI (0.13, 0.61), z = 3.05, df = 9, I2 = 52.6%, P = 0.002] in the overweight not obese subgroup (25 = BMI <30 kg/m2), but no significant effect on the obese subgroup (BMI ≥30 kg/m2). Regular aerobic exercise for more than 24 weeks improved FMD by small effect sizes [SMD = 0.48, 95% CI (0.04, 0.93), z = 2.12, df = 5, I2 = 56.4%, P = 0.034] and for more than three times per week improved FMD by moderate effect sizes [SMD = 0.55, 95% CI (0.12, 0.98), z = 2.50, df = 3, I2 = 31.1%, P = 0.012] in obese and overweight older adults with or without CVD. Conclusion In obese and overweight older adults with or without comorbidity, regular aerobic exercise for more than 24 weeks improved FMD by small effect sizes and exercise for more than three times per week improved FMD by moderate effect sizes and regular aerobic exercise reduced PWV by small effect sizes and had no influence on Aix. Taken together, it was recommended that obese and overweight older adults should adhere to regular aerobic exercise, training at least 3 times per week for better results.
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Affiliation(s)
- Peilun Li
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Ziqing Liu
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Kewen Wan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kangle Wang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Chen Zheng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Junhao Huang
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
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Damay VA, Setiawan, Lesmana R, Akbar MR, Lukito AA, Tarawan VM, Martha JW, Nugroho J, Sugiharto S. Aerobic Exercise versus Electronic Cigarette in Vascular Aging Process: First Histological Insight. Int J Vasc Med 2023; 2023:8874599. [PMID: 37533734 PMCID: PMC10393525 DOI: 10.1155/2023/8874599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 08/04/2023] Open
Abstract
Smoking is related to vascular aging. However, the hazardous effect of e-cigarette is often debatable, with limited studies available. In contrast, moderate-intensity aerobic exercise is well known to decrease aortic stiffness. We provide novel research to determine the effect of e-cigarette and aerobic moderate-intensity exercise on the aortic structure of Wistar rats. A total of 26 male Wistar rats (Rattus norvegicus) 8 weeks aged, 200-250 g b.w., were randomly divided into 4 groups, namely, K0 (normal rats), K1 (rats were given moderate-intensity aerobic exercise by animal treadmill 20 m/30 min), K2 (rats were given e-cigarette with 6 mg nicotine, 40% propylene glycol, and 60% vegetable glycerine 30 min for 5 days/week), and K3 (rats were given e-cigarette and moderate-intensity aerobic exercise). After exposure for 6 weeks, all animals were sacrificed to isolate the aorta for histopathological analysis with hematoxylin-eosin stain to evaluate the elastic fiber layer and intimal-medial thickness. The Verhoeff-Van Gieson staining was done for quantification elastic lamina fragmentation. Our study found that the e-cigarette group had the highest elastic lamina fragmentation among groups (8.14 ± 2.85). The exercise only group showed the lowest elastic lamina fragmentation (2.50 ± 1.87). Fragmentation in the e-cigarette and exercise group was higher than in the exercise only group (5.83 ± 0.753 vs. 2.50 ± 1.87, p = 0.002). There is a significant difference of NO serum between four groups. The result of post hoc analysis using LSD showed that there is a significant difference of NO serum between K0 and K2, K0 and K3, K1 and K2, and K1 and K3. Therefore, our research demonstrated that the most injury of aorta elastic lamina was in the group that was exposed to e-cigarette that leads to vascular aging while exercise is not yet proven to reverse this effect.
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Affiliation(s)
- Vito A. Damay
- Department of Cardiovascular Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Setiawan
- Department of Biomedical Sciences, Universitas Padjadjaran, Bandung, Indonesia
| | - Ronny Lesmana
- Department of Biomedical Sciences, Universitas Padjadjaran, Bandung, Indonesia
| | - Muhammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Antonia Anna Lukito
- Department of Cardiovascular Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Vita M. Tarawan
- Department of Biomedical Sciences, Universitas Padjadjaran, Bandung, Indonesia
| | - Januar W. Martha
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - J. Nugroho
- Department of Cardiology and Vascular Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sony Sugiharto
- Department of Anatomical Pathology, Universitas Tarumanegara, Jakarta, Indonesia
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Álvarez-Bustos A, Carnicero JA, Rodríguez-Sánchez B, El-Assar M, Rueda R, Pereira SL, Sepúlveda-Loyola W, Garcia-Garcia FJ, Sulo S, Rodríguez-Mañas L. Association Between Pulse Wave Velocity and Frailty, Disability, and Mortality in Community-Dwelling Older Adults. JACC. ADVANCES 2023; 2:100423. [PMID: 38939008 PMCID: PMC11198582 DOI: 10.1016/j.jacadv.2023.100423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/17/2023] [Accepted: 05/09/2023] [Indexed: 06/29/2024]
Abstract
Background Arterial stiffness leads to several adverse events in the older population, but there is a lack of data on its association with frailty, disability, and mortality in the same population. Objectives The purpose of this study was to evaluate the role of arterial stiffness in the loss of functional ability (frailty and disability) and mortality. Methods Data were taken from community-dwelling aged 65 years participants without diabetes in the Toledo Study of Healthy Ageing cohort. Pulse wave velocity (PWV), assessed through SphygmoCor, was recorded at baseline. Median follow-up time were 2.99 years for frailty (frailty phenotype [FP] and Frailty Trait Scale-5 [FTS5]) and disability (Katz Index) and 6.2 for mortality. Logistic regressions models were built for disability and frailty and Cox proportional hazards model for death, adjusted by age and sex, comorbidity, cardiovascular risk factors, asymmetric dimethylarginine levels, and polypharmacy. Results Overall, 978 (mean age 74.5 ± 5.6 years, 56.7% female) participants were included. Different cut-off points were shown for each outcome. PWV >11.5 m/s was cross-sectionally associated with frailty (FP: OR fully-adjusted model: 1.69, 95% CI: 1.45-1.97; FTS5: OR: 1.51, 95% CI: 1.22-1.87) and disability (OR: 1.51, 95% CI: 1.26-1.79); PWV >10 m/s with incident frailty by FP (OR: 1.36, 95% CI: 1.10-1.68) and FTS5 (OR: 1.40, 95% CI: 1.12-1.75), and PWV >11 m/s with death (HR: 1.28, 95% CI: 1.09-1.50). For incident (OR: 1.28, 95% CI: 1.06-1.55) and worsening disability (OR: 1.21, 95% CI: 1.02-1.45) the threshold was 12.5 m/s. Below these cut-off points, age was the best predictor of adverse outcomes. Conclusions Arterial stiffness predicts frailty, disability, and mortality in older people, with different cut-off points, ie,severity degrees, for each of the assessed outcomes.
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Affiliation(s)
- Alejandro Álvarez-Bustos
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose A. Carnicero
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Fundación de Investigación Biomédica, Hospital Universitario de Getafe, Getafe, Spain
| | - Beatriz Rodríguez-Sánchez
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Economía Aplicada, Economía Pública y Economía Política, Facultad de Derecho, Universidad Complutense de Madrid, Madrid, Spain
| | - Mariam El-Assar
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Fundación de Investigación Biomédica, Hospital Universitario de Getafe, Getafe, Spain
| | | | | | | | - Francisco J. Garcia-Garcia
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Geriatría, Hospital Virgen del Valle, Toledo, Spain
| | - Suela Sulo
- Abbott Nutrition, Chicago, Illinois, USA
| | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain
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Ijaz N. Arterial Stiffness: A Noninvasive Biomarker for Pathological Aging. JACC. ADVANCES 2023; 2:100436. [PMID: 38939005 PMCID: PMC11198378 DOI: 10.1016/j.jacadv.2023.100436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- Naila Ijaz
- Department of Cardiology, Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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8
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de Sousa MKF, Silva RDM, Freire YA, Souto GC, Câmara M, Cabral LLP, Macêdo GAD, Costa EC, Oliveira RS. Associations between physical activity and cardiorespiratory fitness with vascular health phenotypes in older adults: a cross-sectional study. Front Physiol 2023; 14:1096139. [PMID: 37256064 PMCID: PMC10225566 DOI: 10.3389/fphys.2023.1096139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/24/2023] [Indexed: 06/01/2023] Open
Abstract
Objective: We investigated the associations between physical activity (PA) and cardiorespiratory fitness (CRF) with vascular health phenotypes in community-dwelling older adults. Methods: This cross-sectional study included 82 participants (66.8 ± 5.2 years; 81% females). Moderate-to-vigorous physical activity (MVPA) was assessed using accelerometers, and CRF was measured using the distance covered in the 6-min walk test (6MWT). The vascular health markers were as follows: i) arterial function measured as aortic pulse wave velocity (aPWV) estimated using an automatic blood pressure device; and ii) arterial structure measured as the common carotid intima-media thickness (cIMT). Using a combination of normal cIMT and aPWV values, four groups of vascular health phenotypes were created: normal aPWV and cIMT, abnormal aPWV only, abnormal cIMT only, and abnormal aPWV and cIMT. Multiple linear regression was used to estimate the beta coefficients (β) and their respective 95% confidence intervals (95% CI) adjusting for BMI, and medication for diabetes, lipid, and hypertension, sex, age, and blood pressure. Results: Participants with abnormal aPWV and normal cIMT (β = -53.76; 95% CI = -97.73--9.78 m; p = 0.017), and participants with both abnormal aPWV and cIMT (β = -71.89; 95% CI = -125.46--18.31 m; p = 0.009) covered less distance in the 6MWT, although adjusting for age, sex and blood pressure decreased the strength of the association with only groups of abnormal aPWV and cIMT covering a lower 6MWT distance compared to participants with both normal aPWV and cIMT (β = -55.68 95% CI = -111.95-0.59; p = 0.052). No associations were observed between MVPA and the vascular health phenotypes. Conslusion: In summary, poor CRF, but not MVPA, is associated with the unhealthiest vascular health phenotype (abnormal aPWV/cIMT) in older adults.
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Affiliation(s)
| | - Raíssa de Melo Silva
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Department of Physical Education, ExCE Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Yuri Alberto Freire
- Department of Physical Education, ExCE Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Gabriel Costa Souto
- Department of Physical Education, ExCE Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Marcyo Câmara
- Department of Physical Education, ExCE Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ludmila Lucena Pereira Cabral
- Department of Physical Education, ExCE Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Geovani Araújo Dantas Macêdo
- Department of Physical Education, ExCE Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Eduardo Caldas Costa
- Department of Physical Education, ExCE Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ricardo Santos Oliveira
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- INTEGRA—Integrative Physiology, Health, and Performance Research Group, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Teixeira JMM, Motta-Santos D, Milanovic Z, Pereira RL, Krustrup P, Póvoas S. Intermittent high-intensity exercise for pre- to established hypertension: A systematic review and meta-analysis. Scand J Med Sci Sports 2023; 33:364-381. [PMID: 36579740 DOI: 10.1111/sms.14299] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/30/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the impact of intermittent high-intensity exercise training ([IHIE], including high-intensity interval training [HIIT] and recreational team sports [RTS]) on systolic (SBP) and diastolic blood pressure (DBP) in adults with pre- to established arterial hypertension. DATA SOURCES MEDLINE, Cochrane Library, Embase, and SPORTDiscus. ELIGIBILITY CRITERIA Randomized controlled trials (RCTs) comparing the impact of IHIE on BP versus a non-exercise control. DATA COLLECTION AND ANALYSIS Two authors independently conducted all procedures. Mean differences were calculated using random-effects model. The certainty of the evidence was assessed with GRADE. RESULTS Twenty-seven RCTs (18 HIIT and 9 RTS) were analyzed, with median duration of 12 weeks. Participants' (n = 946) median age was 46 years. Overall, IHIE decreased SBP (-3.29 mmHg; 95% CI: -5.19, -1.39) and DBP (-2.62 mmHg; 95% CI: -3.79, -1.44) compared to the control group. IHIE elicited higher decreases in office SBP and DBP of hypertensive subjects (SBP: -7.13 mmHg, [95% CI: -10.12, -4.15]; DBP: -5.81 mmHg, [95% CI: -7.94, -3.69]) than pre-hypertensive (SBP: -2.14 mmHg, [95% CI: -4.36, -0.08]; DBP: -1.83 mmHg, [95% CI: -2.99, -0.67]). No significant differences were found between HIIT (SBP: -2.12 mmHg, [95% CI: -4.78, -0.54]; DBP: -1.89 mmHg, [95% CI: -3.32, -0.48]) and RTS (SBP: -4.18 mmHg, [95% CI: -7.19, -2.43]; DBP: -4.04 mmHg, [95% CI: -6.00, -2.09]). These findings present low/very low certainty of evidence. No adverse cardiovascular events were reported. CONCLUSIONS IHIE appears to be safe and to promote substantial decreases in BP, particularly in patients with hypertension. However, the certainty of evidence was low/very low. PROTOCOL CRD42020163575.
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Affiliation(s)
- Jorge M M Teixeira
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Daisy Motta-Santos
- Sports Department, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Zoran Milanovic
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia.,Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia.,Faculty of Sports Studies, Incubator of Kinanthropological Research, Masaryk University, Brno, Czech Republic
| | - Rita L Pereira
- Laboratory of Metabolism and Exercise, Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,University of Maia, Maia, Portugal
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark.,Sport and Health Sciences, College of Life and Environment Sciences, University of Exeter, Exeter, UK.,Department of Physical Education and Sports Training, Shanghai University of Sport (SUS), Shanghai, China.,Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
| | - Susana Póvoas
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
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10
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Streese L, Habisch H, Deiseroth A, Carrard J, Infanger D, Schmidt-Trucksäss A, Madl T, Hanssen H. Lipoprotein Subclasses Independently Contribute to Subclinical Variance of Microvascular and Macrovascular Health. Molecules 2022; 27:molecules27154760. [PMID: 35897932 PMCID: PMC9332701 DOI: 10.3390/molecules27154760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Lipoproteins are important cardiovascular (CV) risk biomarkers. This study aimed to investigate the associations of lipoprotein subclasses with micro- and macrovascular biomarkers to better understand how these subclasses relate to atherosclerotic CV diseases. One hundred and fifty-eight serum samples from the EXAMIN AGE study, consisting of healthy individuals and CV risk patients, were analysed with nuclear magnetic resonance (NMR) spectroscopy to quantify lipoprotein subclasses. Microvascular health was quantified by measuring retinal arteriolar and venular diameters. Macrovascular health was quantified by measuring carotid-to-femoral pulse wave velocity (PWV). Nineteen lipoprotein subclasses showed statistically significant associations with retinal vessel diameters and nine with PWV. These lipoprotein subclasses together explained up to 26% of variation (R2 = 0.26, F(29,121) = 2.80, p < 0.001) in micro- and 12% (R2 = 0.12, F(29,124) = 1.70, p = 0.025) of variation in macrovascular health. High-density (HDL-C) and low-density lipoprotein cholesterol (LDL-C) as well as triglycerides together explained up to 13% (R2 = 0.13, F(3143) = 8.42, p < 0.001) of micro- and 8% (R2 = 0.08, F(3145) = 5.46, p = 0.001) of macrovascular variation. Lipoprotein subclasses seem to reflect micro- and macrovascular end organ damage more precisely as compared to only measuring HDL-C, LDL-C and triglycerides. Further studies are needed to analyse how the additional quantification of lipoprotein subclasses can improve CV risk stratification and CV disease prediction.
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Affiliation(s)
- Lukas Streese
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, 4052 Basel, Switzerland; (L.S.); (A.D.); (J.C.); (D.I.); (A.S.-T.); (H.H.)
| | - Hansjörg Habisch
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria;
| | - Arne Deiseroth
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, 4052 Basel, Switzerland; (L.S.); (A.D.); (J.C.); (D.I.); (A.S.-T.); (H.H.)
| | - Justin Carrard
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, 4052 Basel, Switzerland; (L.S.); (A.D.); (J.C.); (D.I.); (A.S.-T.); (H.H.)
| | - Denis Infanger
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, 4052 Basel, Switzerland; (L.S.); (A.D.); (J.C.); (D.I.); (A.S.-T.); (H.H.)
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, 4052 Basel, Switzerland; (L.S.); (A.D.); (J.C.); (D.I.); (A.S.-T.); (H.H.)
| | - Tobias Madl
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Molecular Biology and Biochemistry, Medical University of Graz, 8010 Graz, Austria;
- BioTechMed Graz, 8010 Graz, Austria
- Correspondence: ; Tel.: +43-316-385-71972
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, 4052 Basel, Switzerland; (L.S.); (A.D.); (J.C.); (D.I.); (A.S.-T.); (H.H.)
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11
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Hanssen H, Streese L, Vilser W. Retinal vessel diameters and function in cardiovascular risk and disease. Prog Retin Eye Res 2022; 91:101095. [PMID: 35760749 DOI: 10.1016/j.preteyeres.2022.101095] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/03/2022] [Accepted: 06/13/2022] [Indexed: 12/13/2022]
Abstract
In the last two decades evidence has gradually accumulated suggesting that the eye may be a unique window for cardiovascular risk stratification based on the assessment of subclinical damage of retinal microvascular structure and function. This can be facilitated by non-invasive analysis of static retinal vessel diameters and dynamic recording of flicker light-induced and endothelial function-related dilation of both retinal arterioles and venules. Recent new findings have made retinal microvascular biomarkers strong candidates for clinical implementation as reliable risk predictors. Beyond a review of the current evidence and state of research, the article aims to discuss the methodological benefits and pitfalls and to identify research gaps and future directions. Above all, the potential use for screening and treatment monitoring of cardiovascular disease risk are highlighted. The article provides fundamental comprehension of retinal vessel imaging by explaining anatomical and physiological essentials of the retinal microcirculation leading to a detailed description of the methodological approach. This allows for better understanding of the underlying retinal microvascular pathology associated with the prevalence and development of cardiovascular disease. A body of new evidence is presented on the clinical validity and predictive value of retinal vessel diameters and function for incidence cardiovascular disease and outcome. Findings in children indicate the potential for utility in childhood cardiovascular disease prevention, and the efficacy of exercise interventions highlight the treatment sensitivity of retinal microvascular biomarkers. Finally, coming from the availability of normative data, solutions for diagnostic challenges are discussed and conceptual steps towards clinical implementation are put into perspective.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland.
| | - Lukas Streese
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland
| | - Walthard Vilser
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany; Neonatology and Pediatric Intensive Care Unit, Department of Pediatrics, Jena University Hospital, Jena, Germany
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12
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Physical Performance, Cardiovascular Health and Psychosocial Wellbeing in Older Adults Compared to Oldest-Old Residential Seniors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031451. [PMID: 35162467 PMCID: PMC8835371 DOI: 10.3390/ijerph19031451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/26/2022] [Indexed: 02/04/2023]
Abstract
Background: This study analyzed physical, cardiovascular, and psychosocial health in different age groups at the far end of the lifespan. Methods: Sixty-two residential seniors participated in this cross-sectional study and were assigned according to age to either the older adults (n = 27; age: 74.8 (3.6); f: 23) or the oldest-old group (n = 35; age: 87.2 (5.0); f: 28). Gait speed, functional mobility, handgrip strength, and pulse wave velocity (PWV) were measured. Additionally, questionnaires to assess quality of life were applied. Mean between-group differences (Δ) and Hedge’s g with 95 % confidence intervals were calculated. Results: Oldest-old had moderately lower handgrip strength (Δ = −31.3 N, 95% CI [−66.30; −1.65], Hedge’s g = 0.49 [−0.97; 0.03]) and relevant lower gait speed than the older adults (Δ = −0.11 m/s [−0.28; 0.05], g = 0.34 [−0.89; 0.20]). All other physical parameters showed trivial differences. Very large effects were found in PWV in favor of the older adults (Δ = −2.65 m/s [−3.26; −2.04], g = −2.14 [−2.81; −1.36]). The questionnaires showed trivial to small differences. Conclusion: We found small differences in physical as well as psychosocial health between age groups with large inter-individual variance. Large differences were found in arterial stiffness, which increases with age. Exercise programs in nursing homes should consider physical, psychosocial, and cardiovascular variables more than age.
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13
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Love KM, Horton WB, Patrie JT, Jahn LA, Hartline LM, Barrett EJ. Predictors of arterial stiffness in adolescents and adults with type 1 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2022; 10:e002491. [PMID: 34987053 PMCID: PMC8734015 DOI: 10.1136/bmjdrc-2021-002491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/10/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Individuals with type 1 diabetes have increased arterial stiffness compared with age-matched healthy controls. Our aim was to determine which hemodynamic and demographic factors predict arterial stiffness in this population. RESEARCH DESIGN AND METHODS Carotid-femoral pulse wave velocity (cfPWV) was examined in 41 young adults and adolescents with type 1 diabetes without microvascular complications. Two ordinary least squares regression analyses were performed to determine multivariate relationships between cfPWV (loge) and (1) age, duration of diabetes, sex, and hemoglobin A1c and (2) augmentation index (AIx), mean arterial pressure, flow-mediated dilation (FMD), and heart rate. We also examined differences in macrovascular outcome measures between sexes. RESULTS Age, sex, and FMD provided unique predictive information about cfPWV in these participants with type 1 diabetes. Despite having similar cardiovascular risk factors, men had higher cfPWV compared with women but no differences were observed in other macrovascular outcomes (including FMD and AIx). CONCLUSIONS Only age, sex, and FMD were uniquely associated with arterial stiffness in adolescents and adults with uncomplicated type 1 diabetes. Women had less arterial stiffness and similar nitric oxide-dependent endothelial function compared with men. Larger, prospective investigation is warranted to determine the temporal order of and sex differences in arterial dysfunction in type 1 diabetes.
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Affiliation(s)
- Kaitlin M Love
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - William B Horton
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - James T Patrie
- Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Linda A Jahn
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Lee M Hartline
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Eugene J Barrett
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
- Department of Pharmacology, University of Virginia Health System, Charlottesville, Virginia, USA
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14
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Ogola BO, Clark GL, Abshire CM, Harris NR, Gentry KL, Gunda SS, Kilanowski-Doroh I, Wong TJ, Visniauskas B, Lawrence DJ, Zimmerman MA, Bayer CL, Groban L, Miller KS, Lindsey SH. Sex and the G Protein-Coupled Estrogen Receptor Impact Vascular Stiffness. Hypertension 2021; 78:e1-e14. [PMID: 34024124 PMCID: PMC8192475 DOI: 10.1161/hypertensionaha.120.16915] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Benard O. Ogola
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | - Gabrielle L. Clark
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Caleb M. Abshire
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Kaylee L. Gentry
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | - Shreya S. Gunda
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Tristen J. Wong
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Dylan J. Lawrence
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | | | - Carolyn L. Bayer
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kristin S. Miller
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Sarah H. Lindsey
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
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15
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Qin S, Basak C. Comparing the effects of two cardiovascular health factors on working memory capacity in healthy aging: separate and combined effects of arterial elasticity and physical fitness. J Gerontol B Psychol Sci Soc Sci 2021; 77:94-103. [PMID: 33914083 DOI: 10.1093/geronb/gbab071] [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: 12/30/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Arterial elasticity and physical fitness are two important cardiovascular health factors that influence cognition in older adults. Working memory capacity (WMC), a core component underlying cognitive aging across many cognitive domains, may be affected by individual differences in cardiovascular health in older adults. The current study aims to identify in older adults: 1) separate and combined effects of these two cardiovascular health factors on WMC, and 2) which of the two factors is more critical in influencing WMC. METHOD WMC in 89 healthy older adults was assessed by two complex span tasks. Arterial elasticity was assessed by pulse pressure (PsP). Physical fitness was measured by an established proxy of VO2Max (MET). Effects of PsP and MET on WMC were evaluated via step-wise regressions. RESULTS After controlling for age, sex, and education, PsP and MET were separately predictive of WMC in older adults. Together, the combined effect of PsP and MET was more predictive of WMC than fitness alone, but not more than PsP alone. Mediation analysis indicates that the relationship between MET and WMC was completely mediated by PsP. DISCUSSION The current study innovatively demonstrates that though arterial elasticity and physical fitness separately predict WMC, the former completely mediates the relationship between fitness and WMC. This suggests that biologically-based cardiovascular health factors like arterial elasticity are crucial individual difference variables that should be measured and monitored in cognitive aging studies as well as in physical interventions that are designed to improve cognition in healthy aging.
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Affiliation(s)
- Shuo Qin
- Center for Vital Longevity, the University of Texas at Dallas
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16
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Saz-Lara A, Cavero-Redondo I, Álvarez-Bueno C, Notario-Pacheco B, Reina-Gutiérrez S, Sequí-Domínguez I, Ruiz JR, Martínez-Vizcaíno V. What type of physical exercise should be recommended for improving arterial stiffness on adult population? A network meta-analysis. Eur J Cardiovasc Nurs 2021; 20:696-716. [PMID: 33837399 DOI: 10.1093/eurjcn/zvab022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/27/2021] [Accepted: 03/10/2021] [Indexed: 12/24/2022]
Abstract
AIMS Physical exercise has been associated with a reduction in arterial stiffness, a subclinical process underlying cardiovascular disease. However, the effect of different types of exercise (aerobic, resistance, combined, interval training, stretching, or mind-body modalities) on arterial stiffness is unclear. This network meta-analysis aimed to examine the effectiveness of different types of exercise on arterial stiffness as measured by pulse wave velocity in adults. METHODS AND RESULTS We searched Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE (via Pubmed), Embase, and Web of Science databases, for randomized clinical trials including at least a comparison group, from their inception to 30 June 2020. A frequentist network meta-analysis was performed to compare the effect of different types of physical exercise on arterial stiffness as measured by pulse wave velocity. Finally, 35 studies, with a total of 1125 participants for exercise intervention and 633 participants for the control group, were included. In the pairwise meta-analyses, the exercises that improved arterial stiffness were: interval training [effect size (ES) 0.37; 95% confidence interval (CI) 0.01-0.73], aerobic exercise (ES 0.30; 95% CI 0.13-0.48) and combined exercise (ES 0.22; 95% CI 0.04-0.40). Furthermore, the network meta-analysis showed that mind-body interventions were the most effective type of exercise to reduce the pulse wave velocity (ES 0.86; 95% CI 0.04-1.69). In addition, combined exercise (ES 0.35; 95% CI 0.08-0.62), aerobic exercise (ES 0.33; 95% CI 0.09-0.57), and interval training (ES 0.33; 95% CI 0.02-0.64) showed significant improvements. CONCLUSION Our findings showed that aerobic exercise, combined exercise, interval training, and mind-body exercises were the most effective exercise modalities for reducing arterial stiffness, assuming an important role in the prevention of cardiovascular diseases.
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Affiliation(s)
- Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain.,Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Av. República 71, Santiago, Chile
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Mayor Sebastián Bullo, 001518 Asunción, Paraguay
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Sara Reina-Gutiérrez
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Irene Sequí-Domínguez
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through physical activity Research Group (PROFITH), Department of Physical Activity and Sports Education, Sport and Health, University Research Institute (iMUDS), Faculty of Sports Science, University of Granada, Crta Alfacar s/n. 18011 Granada, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain.,Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Av. Pedro de Valdivia 425, Talca, Chile
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17
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Wernhart S, Hedderich J, Weihe E. Vital capacity and valvular dysfunction could serve as non-invasive predictors to screen for exercise pulmonary hypertension in the elderly based on a new diagnostic score. J Cardiovasc Thorac Res 2021; 13:68-78. [PMID: 33815705 PMCID: PMC8007893 DOI: 10.34172/jcvtr.2021.05] [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: 09/18/2020] [Accepted: 01/05/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction: Exercise pulmonary hypertension (exPH) has been defined as total pulmonary resistance (TPR) >3 mm Hg/L/min and mean pulmonary artery pressure (mPAP) >30 mm Hg, albeit with a considerable risk of false positives in elderly patients with lower cardiac output during exercise.
Methods: We retrospectively analysed patients with unclear dyspnea receiving right heart catheterisation at rest and exercise (n=244) between January 2015 and January 2020. Lung function testing, blood gas analysis, and echocardiography were performed. We elaborated a combinatorial score to advance the current definition of exPH in an elderly population (mean age 67.0 years±11.9). A stepwise regression model was calculated to non-invasively predict exPH.
Results: Analysis of variables across the achieved peak power allowed the creation of a model for defining exPH, where three out of four criteria needed to be fulfilled: Peak power ≤100 Watt, pulmonary capillary wedge pressure ≥18 mm Hg, pulmonary vascular resistance >3 Wood Units, and mPAP ≥35 mm Hg. The new scoring model resulted in a lower number of exPH diagnoses than the current suggestion (63.1% vs. 78.3%). We present a combinatorial model with vital capacity (VCmax) and valvular dysfunction to predict exPH (sensitivity 93.2%; specificity 44.2%, area under the curve 0.73) based on our suggested criteria. The odds of the presence of exPH were 2.1 for a 1 l loss in VCmax and 3.6 for having valvular dysfunction.
Conclusion: We advance a revised definition of exPH in elderly patients in order to overcome current limitations. We establish a new non-invasive approach to predict exPH by assessing VCmax and valvular dysfunction for early risk stratification in elderly patients.
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Affiliation(s)
- Simon Wernhart
- Department of Cardiology, Fachkrankenhaus Kloster Grafschaft, Schmallenberg, Germany.,University Hospital Essen, University Duisburg-Essen, West German Heart- and Vascular Center, Department of Cardiology and Vascular Medicine, Hufelandstrasse 55, 45147 Essen, Germany
| | - Jürgen Hedderich
- Medistat-Biomedical Statistics, Medistat GmbH, Kronshagen, Germany
| | - Eberhard Weihe
- Institute of Anatomy and Cell Biology of the Philipps-University Marburg, Germany
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18
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Chao HH, Liao YH, Chou CC. Influences of Recreational Tennis-Playing Exercise Time on Cardiometabolic Health Parameters in Healthy Elderly: The ExAMIN AGE Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031255. [PMID: 33573269 PMCID: PMC7908508 DOI: 10.3390/ijerph18031255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Aging and chronic degeneration are the primary threats to cardiometabolic health in elderly populations. Regular appropriate exercise would benefit the advanced aging population. PURPOSE This study investigates whether the degree of weekly tennis participation exhibits differences in primary cardiometabolic parameters, including arterial stiffness, inflammation, and metabolic biomarkers in elderly tennis players. METHODS One hundred thirty-five long-term participants in elder tennis (>50 years old) were initially screened. Twenty-six eligible and voluntary subjects were divided into high tennis time group (HT) (14 ± 1.3 h/week) and low tennis time group (LT) (4.5 ± 0.7 h/week) by stratification analysis based on the amount of tennis playing activity time. The brachial-ankle pulse wave velocity (baPWV), blood pressure, ankle-brachial index (ABI), blood metabolic biomarkers, and insulin resistance were measured to compare the difference between HT and LT groups. RESULTS The baPWV was significantly lower in the HT group than that in the LT group (1283.92 ± 37.01 vs. 1403.69 ± 53.71 cm/s, p < 0.05). We also found that the HT insulin-resistant homeostasis model assessment (HOMA-IR) was significantly lower than that of LT (1.41 ± 0.11 vs. 2.27 ± 0.48 μIU/mL, p < 0.05). However, the blood lipid biomarkers (glucose, cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride) were not statistical different between HT and LT groups (p > 0.05). CONCLUSION We demonstrated that under the condition of similar daily physical activity level, elderly with a higher time of tennis-playing (HT group) exhibited relatively lower arterial stiffness (lower PWV) and lower insulin resistance compared to those with lower time tennis-playing (LT).
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Affiliation(s)
- Hsiao-Han Chao
- Department of Athletics, National Taiwan University, Taipei 10617, Taiwan;
| | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan;
| | - Chun-Chung Chou
- Physical Education Office, National Taipei University of Technology, Taipei 10608, Taiwan
- Correspondence: ; Tel.: +886-2-27712171 (ext. 3332)
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19
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Lona G, Hauser C, Köchli S, Infanger D, Endes K, Faude O, Hanssen H. Blood Pressure Increase and Microvascular Dysfunction Accelerate Arterial Stiffening in Children: Modulation by Physical Activity. Front Physiol 2020; 11:613003. [PMID: 33391029 PMCID: PMC7773656 DOI: 10.3389/fphys.2020.613003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Background Atherosclerotic remodeling starts early in life and can accelerate in the presence of cardiovascular risk (CV) factors. Regular physical activity (PA) can mitigate development of large and small artery disease during lifespan. We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years. Methods The school-based prospective cohort study included 262 children initially aged 6–8 years, assessing the above CV risk factors and retinal vessels by standardized procedures at baseline (2014) and follow-up (2018). PWV was assessed by an oscillometric device at follow-up. Results Children with increased systolic BP over 4 years showed higher PWV at follow-up (β [95% CI] 0.006 [0.002 to 0.011] mmHg per unit, P = 0.002). In contrast, increased vigorous PA corresponded to a lower PWV at follow-up (β [95% CI] −0.009 [−0.018 to <0−0.001] 10 min/day per unit, P = 0.047). Progression of retinal arteriolar narrowing and venular widening were linked to a higher PWV after 4 years (β [95% CI] −0.014 [−0.023 to −0.004] 0.01 changes per unit, P = 0.003). Conclusion Increase in systolic BP and progression of microvascular dysfunction were associated with higher PWV after 4 years. Children with increasing levels of vigorous PA were found to have lower PWV at follow-up. Habitual vigorous PA has the potential to decelerate the process of early vascular aging in children and may thus help counteract CV disease development later in life. Clinical Trial Registration ClinicalTrials.gov, Identifier: NCT03085498.
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Affiliation(s)
- Giulia Lona
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Christoph Hauser
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Sabrina Köchli
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Katharina Endes
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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Buckley BJR, Thijssen DHJ, Lip GYH. Physical activity or fitness as medicine for your arteries? Int J Clin Pract 2020; 74:e13688. [PMID: 33459472 DOI: 10.1111/ijcp.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/21/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Benjamin J R Buckley
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool John Moores University, Liverpool, UK
| | - Dick H J Thijssen
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool John Moores University, Liverpool, UK
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21
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Streese L, Guerini C, Bühlmayer L, Lona G, Hauser C, Bade S, Deiseroth A, Hanssen H. Physical activity and exercise improve retinal microvascular health as a biomarker of cardiovascular risk: A systematic review. Atherosclerosis 2020; 315:33-42. [DOI: 10.1016/j.atherosclerosis.2020.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/03/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023]
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22
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The Effect of Exercise on the Older Adult's Blood Pressure Suffering Hypertension: Systematic Review and Meta-Analysis on Clinical Trial Studies. Int J Hypertens 2020; 2020:2786120. [PMID: 33014449 PMCID: PMC7512073 DOI: 10.1155/2020/2786120] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/28/2020] [Indexed: 01/13/2023] Open
Abstract
Background Senescence refers to spontaneous and progressive irreversible degenerative changes in which both the physical and psychological power diminish significantly. Hypertension is the most common cardiovascular disease in the elderly. Several studies have been conducted regarding the effect of exercise on reducing the blood pressure of the elderly, which have found contradictory results. One of the uses of meta-analysis study is responding to these assumptions and resolving the discrepancies. Accordingly, the aim of the present study is to determine the impact of exercise on the blood pressure of older adults. Method In this research, in order to find electronic published papers from 1992 to 2019, the papers published in both domestic and foreign databases including SID, MagIran, IranMedex, IranDox, Gogole Scholar, Cohrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were used. Heterogeneity index between the studies was determined based on Cochran test Q(c) and I2. Considering existence of heterogeneity, random effects model was employed to estimate the standardized subtraction of the mean exercise test score for reduction of blood pressure in the older adults across the intervention group before and after the test. Results In this meta-analysis and systematic review, eventually 69 papers met the inclusion criteria. The total number of participants was 2272 in the pre- and postintervention groups when examining the systolic changes and 2252 subjects in the pre- and postintervention groups when inspecting the diastolic changes. The standardized mean difference in examining the systolic changes before the intervention was 137.1 ± 8.09 and 132.98 ± 0.96 after the intervention; when exploring the diastolic changes, the pre- and postintervention values were 80.3 ± 0.85 and 76.0 ± 6.56, respectively, where these differences were statistically significant (P < 0.01). Conclusion The results of this study indicated that exercise leads to significant reduction in both systolic and diastolic blood pressure. Accordingly, regular exercise can be part of the treatment plan for hypertensive elderly.
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23
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Physical activity and markers of glycation in older individuals: data from a combined cross-sectional and randomized controlled trial (EXAMIN AGE). Clin Sci (Lond) 2020; 134:1095-1105. [DOI: 10.1042/cs20200255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/23/2020] [Accepted: 05/01/2020] [Indexed: 11/17/2022]
Abstract
AbstractBackground: Advanced glycation end products (AGEs) are protein modifications that are predominantly formed from dicarbonyl compounds that arise from glucose and lipid metabolism. AGEs and sedentary behavior have been identified as a driver of accelerated (vascular) aging. The effect of physical activity on AGE accumulation is unknown. Therefore, we investigated whether plasma AGEs and dicarbonyl levels are different across older individuals that were active or sedentary and whether plasma AGEs are affected by high-intensity interval training (HIIT).Methods: We included healthy older active (HA, n=38, 44.7% female, 60.1 ± 7.7 years old) and healthy older sedentary (HS, n=36, 72.2% female, 60.0 ± 7.3 years old) individuals as well as older sedentary individuals with increased cardiovascular risk (SR, n=84, 50% female, 58.7 ± 6.6 years old). The SR group was randomized into a 12-week walking-based HIIT program or control group. We measured protein-bound and free plasma AGEs and dicarbonyls by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) at baseline and after the HIIT intervention.Results: Protein-bound AGE Nε-(carboxymethyl)lysine (CML) was lower in SR (2.6 ± 0.5 μmol/l) and HS (3.1 ± 0.5 μmol/l) than in HA (3.6 ± 0.6 μmol/l; P<0.05) and remained significantly lower after adjustment for several potential confounders. None of the other glycation markers were different between HS and HA. HIIT did not change plasma AGEs and dicarbonyls in SR.Discussion: Although lifestyle interventions may act as important modulators of cardiovascular risk, HIIT is not a potent short-term intervention to reduce glycation in older individuals, underlining the need for other approaches, such as pharmacological agents, to reduce AGEs and lower cardiovascular risk in this population.
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