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Craighead DH, Freeberg KA, Heinbockel TC, Rossman MJ, Jackman RA, McCarty NP, Jankowski LR, Nemkov T, Reisz JA, D’Alessandro A, Chonchol M, Bailey EF, Seals DR. Time-Efficient, High-Resistance Inspiratory Muscle Strength Training Increases Exercise Tolerance in Midlife and Older Adults. Med Sci Sports Exerc 2024; 56:266-276. [PMID: 37707508 PMCID: PMC10840713 DOI: 10.1249/mss.0000000000003291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE This study aimed to determine if time-efficient, high-resistance inspiratory muscle strength training (IMST), comprising 30 inhalation-resisted breaths per day, improves cardiorespiratory fitness, exercise tolerance, physical function, and/or regional body composition in healthy midlife and older adults. METHODS We performed a double-blind, randomized, sham-controlled clinical trial (NCT03266510) testing 6 wk of IMST (30 breaths per day, 6 d·wk -1 , 55%-75% maximal inspiratory pressure) versus low-resistance sham training (15% maximal inspiratory pressure) in healthy men and women 50-79 yr old. Subjects performed a graded treadmill exercise test to exhaustion, physical performance battery (e.g., handgrip strength, leg press), and body composition testing (dual x-ray absorptiometry) at baseline and after 6 wk of training. RESULTS Thirty-five participants (17 women, 18 men) completed high-resistance IMST ( n = 17) or sham training ( n = 18). Cardiorespiratory fitness (V̇O 2peak ) was unchanged, but exercise tolerance, measured as treadmill exercise time during a graded exercise treadmill test, increased with IMST (baseline, 539 ± 42 s; end intervention, 606 ± 42 s; P = 0.01) but not sham training (baseline, 562 ± 39 s; end intervention, 553 ± 38 s; P = 0.69). IMST increased peak RER (baseline, 1.09 ± 0.02; end intervention, 1.13 ± 0.02; P = 0.012), peak ventilatory efficiency (baseline, 25.2 ± 0.8; end intervention, 24.6 ± 0.8; P = 0.036), and improved submaximal exercise economy (baseline, 23.5 ± 1.1 mL·kg -1 ⋅min -1 ; end intervention, 22.1 ± 1.1 mL·kg -1 ⋅min -1 ; P < 0.001); none of these factors were altered by sham training (all P > 0.05). Changes in plasma acylcarnitines (targeted metabolomics analysis) were consistently positively correlated with changes in exercise tolerance after IMST but not sham training. IMST was associated with regional increases in thorax lean mass (+4.4%, P = 0.06) and reductions in trunk fat mass (-4.8%, P = 0.04); however, peripheral muscle strength, muscle power, dexterity, and mobility were unchanged. CONCLUSIONS These data suggest that high-resistance IMST is an effective, time-efficient lifestyle intervention for improving exercise tolerance in healthy midlife and older adults.
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Affiliation(s)
- Daniel H. Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Kaitlin A. Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Thomas C. Heinbockel
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Matthew J. Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Rachel A. Jackman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Narissa P. McCarty
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Lindsey R. Jankowski
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Julie A. Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - E. Fiona Bailey
- Department of Physiology, University of Arizona College of Medicine, Tucson, AZ
| | - Douglas R. Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
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Freeberg KA, Udovich CC, Martens CR, Seals DR, Craighead DH. Dietary Supplementation With NAD+-Boosting Compounds in Humans: Current Knowledge and Future Directions. J Gerontol A Biol Sci Med Sci 2023; 78:2435-2448. [PMID: 37068054 PMCID: PMC10692436 DOI: 10.1093/gerona/glad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Indexed: 04/18/2023] Open
Abstract
Advancing age and many disease states are associated with declines in nicotinamide adenine dinucleotide (NAD+) levels. Preclinical studies suggest that boosting NAD+ abundance with precursor compounds, such as nicotinamide riboside or nicotinamide mononucleotide, has profound effects on physiological function in models of aging and disease. Translation of these compounds for oral supplementation in humans has been increasingly studied within the last 10 years; however, the clinical evidence that raising NAD+ concentrations can improve physiological function is unclear. The goal of this review was to synthesize the published literature on the effects of chronic oral supplementation with NAD+ precursors on healthy aging and age-related chronic diseases. We identified nicotinamide riboside, nicotinamide riboside co-administered with pterostilbene, and nicotinamide mononucleotide as the most common candidates in investigations of NAD+-boosting compounds for improving physiological function in humans. Studies have been performed in generally healthy midlife and older adults, adults with cardiometabolic disease risk factors such as overweight and obesity, and numerous patient populations. Supplementation with these compounds is safe, tolerable, and can increase the abundance of NAD+ and related metabolites in multiple tissues. Dosing regimens and study durations vary greatly across interventions, and small sample sizes limit data interpretation of physiological outcomes. Limitations are identified and future research directions are suggested to further our understanding of the potential efficacy of NAD+-boosting compounds for improving physiological function and extending human health span.
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Affiliation(s)
- Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - CeAnn C Udovich
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Christopher R Martens
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
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Freeberg KA, Craighead DH, Heinbockel TC, Rossman MJ, Jackman RA, Jankowski LR, Ludwig KR, Chonchol M, Bailey EF, Seals DR. Time-efficient, high-resistance inspiratory muscle strength training increases cerebrovascular reactivity in midlife and older adults. Am J Physiol Heart Circ Physiol 2023; 325:H1059-H1068. [PMID: 37682232 PMCID: PMC10908405 DOI: 10.1152/ajpheart.00351.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023]
Abstract
Aging is associated with increased risk for cognitive decline and dementia due in part to increases in systolic blood pressure (SBP) and cerebrovascular dysfunction. High-resistance inspiratory muscle strength training (IMST) is a time-efficient, intensive respiratory training protocol (30 resisted inspirations/day) that lowers SBP and improves peripheral vascular function in midlife/older adults with above-normal SBP. However, whether, and by what mechanisms, IMST can improve cerebrovascular function is unknown. We hypothesized that IMST would increase cerebrovascular reactivity to hypercapnia (CVR to CO2), which would coincide with changes to the plasma milieu that improve brain endothelial cell function and enhance cognitive performance (NIH Toolbox). We conducted a 6-wk double-blind, randomized, controlled clinical trial investigating high-resistance IMST [75% maximal inspiratory pressure (PImax); 6×/wk; 4 females, 5 males] vs. low-resistance sham training (15% PImax; 6×/wk; 2 females, 5 males) in midlife/older adults (age 50-79 yr) with initial above-normal SBP. Human brain endothelial cells (HBECs) were exposed to participant plasma and assessed for acetylcholine-stimulated nitric oxide (NO) production. CVR to CO2 increased after high-resistance IMST (pre: 1.38 ± 0.66 cm/s/mmHg; post: 2.31 ± 1.02 cm/s/mmHg, P = 0.020). Acetylcholine-stimulated NO production increased in HBECs exposed to plasma from after vs. before the IMST intervention [pre: 1.49 ± 0.33; post: 1.73 ± 0.35 arbitrary units (AU); P < 0.001]. Episodic memory increased modestly after the IMST intervention (pre: 95 ± 13; post: 103 ± 17 AU; P = 0.045). Cerebrovascular and cognitive function were unchanged in the sham control group. High-resistance IMST may be a promising strategy to improve cerebrovascular and cognitive function in midlife/older adults with above-normal SBP, a population at risk for future cognitive decline and dementia.NEW & NOTEWORTHY Midlife/older adults with above-normal blood pressure are at increased risk of developing cognitive decline and dementia. Our findings suggest that high-resistance inspiratory muscle strength training (IMST), a novel, time-efficient (5-10 min/day) form of physical training, may increase cerebrovascular reactivity to CO2 and episodic memory in midlife/older adults with initial above-normal blood pressure.
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Affiliation(s)
- Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Thomas C Heinbockel
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Rachel A Jackman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Lindsey R Jankowski
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Katelyn R Ludwig
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - E Fiona Bailey
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona, United States
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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Freeberg KA, Ludwig KR, Chonchol M, Seals DR, Rossman MJ. NAD +-boosting compounds enhance nitric oxide production and prevent oxidative stress in endothelial cells exposed to plasma from patients with COVID-19. Nitric Oxide 2023; 140-141:1-7. [PMID: 37657532 PMCID: PMC10840929 DOI: 10.1016/j.niox.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/10/2023] [Accepted: 08/30/2023] [Indexed: 09/03/2023]
Abstract
SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), induces vascular endothelial dysfunction, but the mechanisms are unknown. We tested the hypothesis that the "circulating milieu" (plasma) of patients with COVID-19 would cause endothelial cell dysfunction (characterized by lower nitric oxide (NO) production), which would be linked to greater reactive oxygen species (ROS) bioactivity and depletion of the critical metabolic co-substrate, nicotinamide adenine dinucleotide (NAD+). We also investigated if treatment with NAD+-boosting compounds would prevent COVID-19-induced reductions in endothelial cell NO bioavailability and oxidative stress. Human aortic endothelial cells (HAECs) were exposed to plasma from men and women (age 18-85 years) who were hospitalized and tested positive (n = 34; 20 M) or negative (n = 13; 10 M) for COVID-19. HAECs exposed to plasma from patients with COVID-19 also were co-incubated with NAD+ precursors nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN). Acetylcholine-stimulated NO production was 27% lower and ROS bioactivity was 54% higher in HAECs exposed to plasma from patients with COVID-19 (both p < 0.001 vs. control); these responses were independent of age and sex. NAD+ concentrations were 30% lower in HAECs exposed to plasma from patients with COVID-19 (p = 0.001 vs. control). Co-incubation with NR abolished COVID-19-induced reductions in NO production and oxidative stress (both p > 0.05 vs. control). Co-treatment with NMN produced similar results. Our findings suggest the circulating milieu of patients with COVID-19 promotes endothelial cell dysfunction, characterized by lower NO bioavailability, greater ROS bioactivity, and NAD+ depletion. Supplementation with NAD+ precursors may exert a protective effect against COVID-19-evoked endothelial cell dysfunction and oxidative stress.
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Affiliation(s)
- Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Katelyn R Ludwig
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA.
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LaRocca TJ, Smith ME, Freeberg KA, Craighead DH, Helmuth T, Robinson MM, Nair KS, Bryan AD, Seals DR. Novel whole blood transcriptome signatures of changes in maximal aerobic capacity in response to endurance exercise training in healthy women. Physiol Genomics 2023. [PMID: 37335021 PMCID: PMC10396280 DOI: 10.1152/physiolgenomics.00017.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/27/2023] [Indexed: 06/21/2023] Open
Abstract
Maximal aerobic exercise capacity (V̇O2max) is one of the strongest predictors of morbidity and mortality. Aerobic exercise training can increase V̇O2max, but inter-individual variability is marked and unexplained physiologically. The mechanisms underlying this variability have major clinical implications for extending human healthspan. Here, we report a novel transcriptome signature related to ΔV̇O2max with exercise training detected in whole-blood RNA. We used RNA-seq to characterize transcriptomic signatures of ΔV̇O2max in healthy women who completed a 16-week, randomized controlled trial comparing supervised, higher vs. lower aerobic exercise training volume and intensity (four training groups, fully crossed). We found significant baseline gene expression differences in subjects who responded to aerobic exercise training with robust vs. little/no ΔV̇O2max, and differentially expressed genes/transcripts were mostly related to inflammatory signaling and mitochondrial function/protein translation. Baseline gene expression signatures associated with robust vs. little/no ΔV̇O2max were also modulated by exercise training in a dose-dependent manner, and they predicted ΔV̇O2max in this and a separate dataset. Collectively, our data demonstrate the potential utility of using whole blood transcriptomics to study the biology of inter-individual variability in responsiveness to the same exercise training stimulus.
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Affiliation(s)
- Thomas J LaRocca
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
- Center for Healthy Aging, Colorado State University, Fort Collins, CO, United States
| | - Meghan E Smith
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
- Center for Healthy Aging, Colorado State University, Fort Collins, CO, United States
| | - Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Timothy Helmuth
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Matthew M Robinson
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, United States
| | - K Sreekumaran Nair
- Endocrinology and Metabolism Division, Mayo Clinic, Rochester, MN, United States
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
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Oh ES, Freeberg KA, Steele CN, Wang W, Farmer‐Bailey H, Coppock ME, Seals DR, Chonchol M, Rossman MJ, Craighead DH, Nowak KL. Cerebrovascular pulsatility index is higher in chronic kidney disease. Physiol Rep 2023; 11:e15561. [PMID: 36636757 PMCID: PMC9837424 DOI: 10.14814/phy2.15561] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023] Open
Abstract
Patients with chronic kidney disease (CKD) are more likely to die of cardiovascular diseases, including cerebrovascular disease, than to progress to end-stage kidney disease. Cerebrovascular dysfunction, characterized by reduced cerebrovascular reactivity, cerebral hypoperfusion, and increased pulsatile flow within the brain, precedes the onset of dementia and is linked to cognitive dysfunction. However, whether impaired cerebrovascular function is present in non-dialysis dependent CKD is largely unknown. Using transcranial Doppler, we compared middle cerebral artery (MCA) blood velocity response to hypercapnia (normalized for blood pressure and end-tidal CO2 ; a measure of cerebrovascular reactivity) and MCA pulsatility index (PI; a measure of cerebrovascular stiffness) in patients with stage 3-4 CKD vs. age-matched healthy controls. We also administered the NIH cognitive toolbox (cognitive function), measured carotid-femoral pulse-wave velocity (PWV; aortic stiffness), and assessed ex vivo nitric oxide (NO) and reactive oxygen species (ROS) production from human brain endothelial cells incubated with serum obtained from study participants. MCA PI was higher in patients with CKD vs. controls; however, normalized MCA blood velocity response to hypercapnia did not differ between groups. Similar results were observed in a validation cohort of midlife and older adults divided by the median estimated glomerular filtration rate (eGFR). MCA PI was associated with greater large-elastic artery stiffness (carotid-femoral PWV), worse executive function (trails B time), lower eGFR, and higher ex vivo ROS production. These data suggest that impaired kidney function is associated with greater cerebrovascular stiffness, which may contribute to the known increased risk for cognitive impairment in patients with CKD.
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Affiliation(s)
- Ester S. Oh
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Kaitlin A. Freeberg
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Cortney N. Steele
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Wei Wang
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Heather Farmer‐Bailey
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - McKinley E. Coppock
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Douglas R. Seals
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Michel Chonchol
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Matthew J. Rossman
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Daniel H. Craighead
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Kristen L. Nowak
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
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Razzaque MS, Jaser SKK, Prado RCR, Freeberg KA, Ludwig KR, Craighead DH, Rossman MJ, Bhagat A, Bock JM, Wiggins CC, Senefeld JW, Wedig IJ, Elmer SJ, Kamm K. Commentaries on Viewpoint: COVID-19 controls causing a kerfuffle. J Appl Physiol (1985) 2022; 133:1222-1225. [PMID: 36342809 PMCID: PMC9665955 DOI: 10.1152/japplphysiol.00536.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mohammed S. Razzaque
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, United States
| | | | | | - Kaitlin A. Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Katelyn R. Ludwig
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Daniel H. Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Matthew J. Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Anumeha Bhagat
- Department of Physiology, Government Medical College and Hospital, Chandigarh, India
| | - Joshua M. Bock
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Isaac J. Wedig
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States,Health Research Institute, Michigan Technological University, Houghton, Michigan, United States
| | - Steven J. Elmer
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States,Health Research Institute, Michigan Technological University, Houghton, Michigan, United States
| | - Kelly Kamm
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States,Health Research Institute, Michigan Technological University, Houghton, Michigan, United States
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Craighead DH, Tavoian D, Freeberg KA, Mazzone JL, Vranish JR, DeLucia CM, Seals DR, Bailey EF. A multi-trial, retrospective analysis of the antihypertensive effects of high-resistance, low-volume inspiratory muscle strength training. J Appl Physiol (1985) 2022; 133:1001-1010. [PMID: 36107991 PMCID: PMC9550580 DOI: 10.1152/japplphysiol.00425.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/31/2022] [Accepted: 09/08/2022] [Indexed: 11/22/2022] Open
Abstract
Above-normal blood pressure (BP) is a primary risk factor for cardiovascular diseases. In a retrospective analysis of five pilot trials, we assessed the BP-lowering effects of high-resistance inspiratory muscle strength training (IMST) in adults aged 18-82 years and the impact of IMST on maximal inspiratory pressure (PIMAX), a gauge of inspiratory muscle strength and independent disease risk factor. Participants were randomized to high-resistance IMST (75% PIMAX) or low-resistance sham (15% PIMAX) training (30 breaths/day, 5-7 days/wk, 6 wk). IMST (n = 67) reduced systolic BP (SBP) by 9 ± 6 mmHg (P < 0.01) and diastolic BP (DBP) by 4 ± 4 mmHg (P < 0.01). IMST-related reductions in SBP and DBP emerged by week 2 of training (-4 ± 8 mmHg and -3 ± 6 mmHg; P ≤ 0.01, respectively) and continued across the 6-wk intervention. SBP and DBP were unchanged with sham training (n = 61, all P > 0.05). Select subject characteristics slightly modified the impact of IMST on BP. Greater reductions in SBP were associated with older age (β = -0.07 ± 0.03; P = 0.04) and greater reductions in DBP associated with medication-naïve BP (β = -3 ± 1; P = 0.02) and higher initial DBP (β = -0.12 ± 0.05; P = 0.04). PIMAX increased with high-resistance IMST and low-resistance sham training, with a greater increase from high-resistance IMST (+20 ± 17 vs. +6 ± 14 cmH2O; P < 0.01). Gains in PIMAX had a modest inverse relation with age (β = -0.20 ± 0.09; P = 0.03) and baseline PIMAX (β = -0.15 ± 0.07; P = 0.04) but not to reductions in SBP or DBP. These compiled findings from multiple independent trials provide the strongest evidence to date that high-resistance IMST evokes clinically significant reductions in SBP and DBP, and increases in PIMAX, in adult men and women.NEW & NOTEWORTHY In young-to-older adult men and women, 6 wk of high-resistance inspiratory muscle strength training lowers casual systolic and diastolic blood pressure by 9 mmHg and 4 mmHg, respectively, with initial reductions observed by week 2 of training. Given blood pressure outcomes with the intervention were only slightly altered by subject baseline characteristics (i.e., age, blood pressure medication, and health status), inspiratory muscle strength training is effective in lowering blood pressure in a broad range of adults.
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Affiliation(s)
- Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Dallin Tavoian
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
| | - Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Josie L Mazzone
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
| | - Jennifer R Vranish
- Department of Integrative Physiology and Health Science, Alma College, Alma, Michigan
| | - Claire M DeLucia
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - E Fiona Bailey
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
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Craighead DH, Freeberg KA, McCarty NP, Rossman MJ, Moreau KL, You Z, Chonchol M, Seals DR. Inspiratory muscle strength training for lowering blood pressure and improving endothelial function in postmenopausal women: comparison with “standard of care” aerobic exercise. Front Physiol 2022; 13:967478. [PMID: 36105300 PMCID: PMC9465043 DOI: 10.3389/fphys.2022.967478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background: High blood pressure (BP), particularly systolic BP (SBP), is the major modifiable risk factor for cardiovascular diseases and related disorders of aging. SBP increases markedly with aging in women such that the prevalence of above-normal SBP (i.e., ≥120 mmHg) in postmenopausal women exceeds rates in age-matched men. This increase in SBP is associated with vascular endothelial dysfunction, mediated by excessive reactive oxygen species-induced oxidative stress and consequent reductions in nitric oxide bioavailability. Moderate-intensity aerobic exercise is a recommended lifestyle strategy for reducing SBP. However, adherence to aerobic exercise guidelines among postmenopausal women is low (<30%) and aerobic exercise does not consistently enhance endothelial function in estrogen-deficient postmenopausal women. High-resistance inspiratory muscle strength training (IMST) is a time-efficient, adherable lifestyle intervention that involves inhaling against resistance through a handheld device (30 breaths/day). Here, we present the protocol for a randomized controlled trial investigating the efficacy of 3 months of high-resistance IMST compared to guideline-based, “standard-of-care” aerobic exercise training for decreasing SBP and improving endothelial function in estrogen-deficient postmenopausal women with above-normal SBP (120–159 mmHg) at baseline (ClinicalTrials.gov Identifier: NCT05000515). Methods: A randomized, single-blind, parallel-group design clinical trial will be conducted in 72 (36/group) estrogen-deficient postmenopausal women with above-normal SBP. Participants will complete baseline testing and then be randomized to either 3 months of high-resistance IMST (30 breaths/day, 6 days/week, 75% maximal inspiratory pressure) or moderate-intensity aerobic exercise training (brisk walking 25 min/day, 6 days/week, 40–60% heart rate reserve). Outcome measures will be assessed after 3 months of either intervention. Following end-intervention testing, participants will abstain from their assigned intervention for 6 weeks, after which BP and endothelial function will be assessed to evaluate the potential persistent effects of the intervention on the primary and secondary outcomes. Discussion: This study is designed to compare the effectiveness of time-efficient, high-resistance IMST to guideline-based aerobic exercise training for lowering SBP and improving endothelial function, and interrogating potential mechanisms of action, in estrogen-deficient postmenopausal women. Clinical Trial Registration:ClinicalTrials.gov, Identifier: NCT05000515.
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Affiliation(s)
- Daniel H. Craighead
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Kaitlin A. Freeberg
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Narissa P. McCarty
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Matthew J. Rossman
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Kerrie L. Moreau
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Veterans Affairs Eastern Colorado Geriatric Research, Educational and Clinical Center, Denver, CO, United States
| | - Zhiying You
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Douglas R. Seals
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- *Correspondence: Douglas R. Seals,
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10
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Abstract
Age-associated cardiovascular (CV) dysfunction increases the risk for CV diseases. Aerobic exercise training can improve CV function, but only a minority of adults meet aerobic exercise guidelines. High-resistance inspiratory muscle strength training is a time-efficient lifestyle intervention that may promote adherence and improve CV function. However, further investigation is needed to translate inspiratory muscle strength training into the public health domain.
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Affiliation(s)
- Daniel H. Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Kaitlin A. Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Grace S. Maurer
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | | | - Douglas R. Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
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11
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Freeberg KA, Heinbockel TC, Rossman MJ, Jackman RA, McCarty NP, Jankowski LR, Nemkov T, Reisz JA, D'Alessandro A, Chonchol M, Bailey EF, Seals DR, Craighead DH. High‐Resistance Inspiratory Muscle Strength Training‐Associated Increases in Exercise Tolerance in Midlife/Older Adults are Related to Circulating Acylcarnitines. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r3869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Maurer GS, Freeberg KA, Seals DR, Craighead DH. Objectively Measured Vigorous‐Intensity Physical Activity is Related to Endothelial Function in Midlife and Older Men but not in Estrogen‐Deficient Postmenopausal Women. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.l7575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Grace S. Maurer
- Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
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13
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Freeberg KA, Craighead DH, Martens CR, You Z, Chonchol M, Seals DR. Nicotinamide Riboside Supplementation for Treating Elevated Systolic Blood Pressure and Arterial Stiffness in Midlife and Older Adults. Front Cardiovasc Med 2022; 9:881703. [PMID: 35620522 PMCID: PMC9127073 DOI: 10.3389/fcvm.2022.881703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Aging is the primary risk factor for cardiovascular diseases, the leading cause of death worldwide. Age-related increases in systolic blood pressure (SBP) link advancing age to cardiovascular disease risk. A key mechanism mediating the increase in SBP with aging is stiffening of the large elastic arteries, which occurs due to increases in oxidative stress, inflammation, and vascular smooth muscle tone. Nicotinamide adenine dinucleotide (NAD+) is a key molecule in energy metabolism and cellular functioning which declines with advancing age and chronic disease. Dietary supplementation with NAD+ precursors, such as nicotinamide riboside, boosts NAD+ bioavailability and may improve cardiovascular health. Here, we present the protocol for a randomized, controlled trial investigating the efficacy of 3 months of oral supplementation with nicotinamide riboside for decreasing SBP and arterial stiffness in midlife and older adults with initial above-normal (120-159 mmHg) SBP (ClinicalTrials.gov Identifier: NCT03821623). The primary outcome is casual (resting) SBP and secondary outcomes include 24-h SBP and aortic stiffness. Other outcomes include assessment of safety; tolerability; adherence; diastolic BP; systemic NAD+ bioavailability; and circulating biomarkers of oxidative stress, inflammation, and sympathoadrenal activity. Methods A randomized, double-blind, placebo-controlled, single-site parallel-group design clinical trial will be conducted in 94 (47/group) midlife and older (age ≥ 50 years) adults with initial above-normal SBP. Participants will complete baseline testing and then will be randomized to either nicotinamide riboside (500 mg, 2×/day, NIAGEN®; ChromaDex Inc.) or placebo supplementation. Outcome measures will be assessed again after 3 months of treatment. Discussion This study is designed to establish the safety and efficacy of the NAD+ boosting compound, nicotinamide riboside, for reducing casual and 24-h SBP and aortic stiffness in midlife and older adults with above-normal SBP at baseline, a population at increased risk of cardiovascular diseases. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT03821623].
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Affiliation(s)
- Kaitlin A. Freeberg
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, Boulder, CO, United States
| | - Daniel H. Craighead
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, Boulder, CO, United States
| | - Christopher R. Martens
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Zhiying You
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Douglas R. Seals
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, Boulder, CO, United States
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14
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Coppock ME, Freeberg KA, Darvish S, Murray KO. Clinical assessments of cerebrovascular health: is there a neED(D) for cerebral shear-mediated dilatation? J Physiol 2022; 600:1287-1289. [PMID: 35128665 PMCID: PMC8930499 DOI: 10.1113/jp282766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/25/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | - Sanna Darvish
- Department of Integrative Physiology, University of Colorado Boulder
| | - Kevin O. Murray
- Department of Integrative Physiology, University of Colorado Boulder
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15
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Craighead DH, Heinbockel TC, Freeberg KA, Rossman MJ, Jackman RA, Jankowski LR, Hamilton MN, Ziemba BP, Reisz JA, D’Alessandro A, Brewster LM, DeSouza CA, You Z, Chonchol M, Bailey EF, Seals DR. Time-Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above-Normal Blood Pressure. J Am Heart Assoc 2021; 10:e020980. [PMID: 34184544 PMCID: PMC8403283 DOI: 10.1161/jaha.121.020980] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/22/2021] [Indexed: 12/13/2022]
Abstract
Background High-resistance inspiratory muscle strength training (IMST) is a novel, time-efficient physical training modality. Methods and Results We performed a double-blind, randomized, sham-controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50-79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long-lasting effects. Thirty-six participants completed high-resistance IMST (75% maximal inspiratory pressure, n=18) or low-resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg (P<0.01) with IMST, which was ≈75% sustained 6 weeks after IMST (P<0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P=0.03); blood pressure was unaffected by sham training (all P>0.05). Twenty-four hour systolic blood pressure was lower after IMST versus sham training (P=0.01). Brachial artery flow-mediated dilation improved ≈45% with IMST (P<0.01) but was unchanged with sham training (P=0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity (P<0.05). IMST decreased C-reactive protein (P=0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness (P>0.05). Conclusions High-resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above-normal initial systolic blood pressure. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03266510.
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Affiliation(s)
| | | | | | - Matthew J. Rossman
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - Rachel A. Jackman
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | | | | | - Brian P. Ziemba
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - Julie A. Reisz
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - L. Madden Brewster
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | | | - Zhiying You
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Michel Chonchol
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - E. Fiona Bailey
- Department of PhysiologyUniversity of Arizona College of MedicineTucsonAZ
| | - Douglas R. Seals
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
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16
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Giersch GEW, Charkoudian N, Pereira T, Edgell H, Freeberg KA, Craighead DH, Neill M, Allison EY, Zapcic AK, Smith KJ, Bock JM, Casey DP, Shenouda N, Ranadive SM, Tremblay JC, Williams AM, Simpson LL, Meah VL, Ruediger SL, Bailey TG, Pereira HM, Lei TH, Perry B, Mündel T, Freemas JA, Worley ML, Baranauskas MN, Carter SJ, Johnson BD, Schlader ZJ, Bates LC, Stoner L, Zieff G, Poles J, Adams N, Meyer ML, Hanson ED, Greenlund IM, Bigalke JA, Carter JR, Kerr ZY, Stanford K, Pomeroy A, Boggess K, de Souza HLR, Meireles A, Arriel RA, Leite LHR, Marocolo M, Chapman CL, Atencio JK, Kaiser BW, Comrada LN, Halliwill JR, Minson CT, Williams JS, Dunford EC, MacDonald MJ, Santisteban KJ, Larson EA, Reed E, Needham KW, Gibson BM, Gillen J, Barbosa TC, Cardoso LLY, Gliemann L, Tamariz-Ellemann A, Hellsten Y, DuBos LE, Babcock MC, Moreau KL, Wickham KA, Vagula M, Moir ME, Klassen SA, Rodrigues A. Commentaries on Point:Counterpoint: Investigators should/should not control for menstrual cycle phase when performing studies of vascular control. J Appl Physiol (1985) 2021; 129:1122-1135. [PMID: 33197376 DOI: 10.1152/japplphysiol.00809.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Gabrielle E W Giersch
- Thermal and Mountain Medicine Division, United States Army Research Institute for Environmental Medicine, Natick, Massachusetts,Oak Ridge Institute for Science and Education, Oak Ridge, Tennnessee
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute for Environmental Medicine, Natick, Massachusetts
| | - T Pereira
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada
| | - H Edgell
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada
| | - Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Matthew Neill
- Department of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Elric Y Allison
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Andrea K Zapcic
- Department of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Kurt J Smith
- Integrative Physiology Lab, Department of Kinesiology and Nutrition, University of Chicago, Chicago, Illinois
| | - Joshua M Bock
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa,Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa,Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Ninette Shenouda
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland, College Park, Maryland
| | - Joshua C Tremblay
- Centre for Heart, Lung and Vascular Health, University of British Columbia–Okanagan, Kelowna, British Columbia, Canada
| | - Alexandra M Williams
- Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
| | - Lydia L Simpson
- Extremes Research Group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, United Kingdom
| | - Victoria L Meah
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Australia,School of Nursing, Midwifery and Social Work, The University of Queensland, Australia
| | - Hugo M Pereira
- Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi, China,Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Blake Perry
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Toby Mündel
- School of Sport Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Jessica A Freemas
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Morgan L Worley
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Marissa N Baranauskas
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Stephen J Carter
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Blair D Johnson
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Zachary J Schlader
- H.H. Morris Human Performance Laboratories, Dept. of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Lauren C Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gabriel Zieff
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jillian Poles
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nathan Adams
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ian M Greenlund
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Jeremy A Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana,Department of Psychology, Montana State University, Bozeman, Montana
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathleen Stanford
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alex Pomeroy
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kim Boggess
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Hiago L R de Souza
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Anderson Meireles
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Rhai A Arriel
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Laura H R Leite
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Moacir Marocolo
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | - Jessica K Atencio
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brendan W Kaiser
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Lindan N Comrada
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | - Jennifer S Williams
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Emily C Dunford
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Emma Reed
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Karen W Needham
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brandon M Gibson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Jenna Gillen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Thales C Barbosa
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Licy L Yanes Cardoso
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | | | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Lyndsey E DuBos
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Matthew C Babcock
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kerrie L Moreau
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Veterans Affairs Eastern Colorado Geriatric Research, Educational and Clinical Center, Denver, Colorado
| | - Kate A Wickham
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | | | - M Erin Moir
- School of Kinesiology, University of Western Ontario, London, Ontario, Canada
| | | | - Alex Rodrigues
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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17
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Sawyer BJ, McMahon N, Thornhill KL, Baughman BR, Mahoney JM, Pattison KL, Freeberg KA, Botts RT. Supra-Versus Submaximal Cycle Ergometer Verification of VO 2max in Males and Females. Sports (Basel) 2020; 8:sports8120163. [PMID: 33322835 PMCID: PMC7764640 DOI: 10.3390/sports8120163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022] Open
Abstract
This study was designed to determine the optimal intensity for verification phase testing (VP) in healthy, young adults. Thirty one young, active participants (16 females) completed a cycle ergometer graded exercise test (GXT) VO2max test and 4 VP tests at 80, 90, 100, and 105% of the maximum wattage achieved during the GXT. GXT and VP VO2max values showed a significant test x sex interaction (p = 0.02). The males elicited significantly higher VO2max values during the GXT, 80%, and 90% when compared to the 105%, (105 vs. GXT: p = 0.05; 105% vs. 80%: p < 0.01; 105% vs. 90%: p = 0.02). There were no significant differences in VO2max across the tests in the females (p > 0.05); 80% of the males achieved their highest VP VO2max during a submaximal VP test compared to only 37.5% of the females. A secondary study conducted showed excellent reliability (ICCs > 0.90) and low variation (CVs < 3%) for the 90% VP. Our findings show that a submaximal verification phase intensity is ideal for young healthy males to elicit the highest VO2max during cycle ergometer testing. For females, a range of intensities (80-105%) produce similar VO2max values. However, the 80% VP yields an unnecessarily high time to exhaustion.
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Affiliation(s)
- Brandon J. Sawyer
- Departments of Kinesiology and Biology, Point Loma Nazarene University, San Diego, CA 92106, USA;
- Correspondence:
| | - Nicholas McMahon
- Department of Kinesiology, Point Loma Nazarene University, San Diego, CA 92106, USA; (N.M.); (K.L.T.); (B.R.B.); (K.L.P.); (K.A.F.)
| | - Kirsten L. Thornhill
- Department of Kinesiology, Point Loma Nazarene University, San Diego, CA 92106, USA; (N.M.); (K.L.T.); (B.R.B.); (K.L.P.); (K.A.F.)
| | - Brett R. Baughman
- Department of Kinesiology, Point Loma Nazarene University, San Diego, CA 92106, USA; (N.M.); (K.L.T.); (B.R.B.); (K.L.P.); (K.A.F.)
| | - Jenny M. Mahoney
- Departments of Kinesiology and Biology, Point Loma Nazarene University, San Diego, CA 92106, USA;
| | - Kai L. Pattison
- Department of Kinesiology, Point Loma Nazarene University, San Diego, CA 92106, USA; (N.M.); (K.L.T.); (B.R.B.); (K.L.P.); (K.A.F.)
| | - Kaitlin A. Freeberg
- Department of Kinesiology, Point Loma Nazarene University, San Diego, CA 92106, USA; (N.M.); (K.L.T.); (B.R.B.); (K.L.P.); (K.A.F.)
| | - Ryan T. Botts
- Department of Mathematical, Information, and Computer Sciences, Point Loma Nazarene University, San Diego, CA 92106, USA;
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Craighead DH, Freeberg KA, Seals DR. Vascular Endothelial Function in Midlife/Older Adults Classified According to 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines. J Am Heart Assoc 2020; 9:e016625. [PMID: 32815446 PMCID: PMC7660773 DOI: 10.1161/jaha.120.016625] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Impaired endothelial function is thought to contribute to the increased cardiovascular risk associated with above‐normal blood pressure (BP). However, the association between endothelial function and BP classified by 2017 American College of Cardiology/American Heart Association guidelines is unknown. Our objective was to determine if endothelial function decreases in midlife/older adults across the 2017 American College of Cardiology/American Heart Association guidelines BP classifications and identify associated mechanisms of action. Methods and Results A retrospective analysis of endothelial function (brachial artery flow‐mediated dilation) from 988 midlife/older adults (aged 50+ years) stratified by BP status (normal BP; elevated BP; stage 1 hypertension; stage 2 hypertension) was performed. Endothelium‐independent dilation (sublingual nitroglycerin), reactive oxygen species–mediated suppression of endothelial function (∆brachial artery flow‐mediated dilation with vitamin C infusion), and endothelial cell and plasma markers of oxidative stress and inflammation were assessed in subgroups. Compared with normal BP (n=411), brachial artery flow‐mediated dilation was 12% (P=0.04), 15% (P<0.01) and 20% (P<0.01) lower with elevated BP (n=173), stage 1 hypertension (n=248) and stage 2 hypertension (n=156), respectively, whereas endothelium‐independent dilation did not differ (P=0.14). Vitamin C infusion increased brachial artery flow‐mediated dilation in those with above‐normal BP (P≤0.02) but not normal BP (P=0.11). Endothelial cell p47phox (P<0.01), a marker of superoxide/reactive oxygen species–generating nicotinamide adenine dinucleotide phosphate oxidase, and circulating interleukin‐6 concentrations (P=0.01) were higher in individuals with above‐normal BP. Conclusions Vascular endothelial function is progressively impaired with increasing BP in otherwise healthy adults classified by 2017 American College of Cardiology/American Heart Association guidelines. Impaired endothelial function with above‐normal BP is mediated by excessive reactive oxygen species signaling associated with increased endothelial expression of nicotinamide adenine dinucleotide phosphate oxidase and circulating interleukin‐6.
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Affiliation(s)
- Daniel H Craighead
- Department of Integrative Physiology University of Colorado Boulder Boulder CO
| | - Kaitlin A Freeberg
- Department of Integrative Physiology University of Colorado Boulder Boulder CO
| | - Douglas R Seals
- Department of Integrative Physiology University of Colorado Boulder Boulder CO
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Craighead DH, Ziemba BP, Freeberg KA, Rossman MJ, Brown BC, Nemkov T, Reisz JA, D’Alessandro A, Chonchol M, Bailey EF, Seals DR. Inspiratory Muscle Strength Training Improves Vascular Endothelial Function in Older Adults by Altering Circulating Factors that Suppress Superoxide and Enhance Nitric Oxide. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.04717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Freeberg KA, McCarty NP, Seals DR, Craighead DH. Higher Maximal Cardiorespiratory Fitness is Associated with Lower Cerebrovascular Stiffness in Healthy Mid‐Life and Older Adults. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.04271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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McCarty NP, Craighead DH, Freeberg KA. Overcoming exercise barriers: home-based HIT for reducing cardiovascular disease risk in obese individuals. J Physiol 2019; 598:13-14. [PMID: 31670382 DOI: 10.1113/jp279074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Narissa P McCarty
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Daniel H Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Kaitlin A Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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Craighead DH, Freeberg KA, Seals DR. The protective role of regular aerobic exercise on vascular function with aging. Current Opinion in Physiology 2019. [DOI: 10.1016/j.cophys.2019.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Freeberg KA, Craighead DH, Seals DR. Vascular Endothelial Function is Impaired in Adults with Above‐Normal Blood Pressure According to 2017 ACC/AHA Blood Pressure Guidelines. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.696.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Freeberg KA, Baughman BR, Vickey T, Sullivan JA, Sawyer BJ. Assessing the ability of the Fitbit Charge 2 to accurately predict VO 2max. Mhealth 2019; 5:39. [PMID: 31620466 PMCID: PMC6789195 DOI: 10.21037/mhealth.2019.09.07] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/23/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the ability of the Fitbit Charge 2 (FBC2) to accurately estimate VO2max in comparison to both the gold standard VO2max test and a non-exercise VO2max prediction equation. METHODS Thirty healthy subjects (17 men, 13 women) between the ages of 18 and 35 (age =21.7±3.1 years) were given a FBC2 to wear for seven days and followed instructions on how to obtain a cardio fitness score (CFS). VO2max was measured with an incremental test on the treadmill followed by a verification phase. VO2max was predicted via a non-exercise prediction model (N-Ex) using self-reported physical activity level. RESULTS Measured VO2max was significantly lower than FBC2 predicted CFS (VO2max =49.91±6.83; CFS =52.53±8.43, P=0.03). N-Ex prediction was significantly lower than CFS but not significantly lower than measured VO2max (N-Ex =48.79±6.32; CFS vs. N-Ex: P=0.01; VO2max vs. N-Ex: P=0.54). Relationships between both VO2max vs. CFS and VO2max vs. N-Ex were good (ICC: VO2max vs. CFS=0.87, VO2max vs. N-Ex =0.87); Bland-Altman analysis indicated consistency of CFS measurement and lack of bias. The coefficient of variation (CV) and mean absolute percent error (MAPE) were greater with CFS than N-Ex (CV: CFS =6.5%±4.1%, N-Ex =5.6%±3.6%; MAPE: CFS =10.2%±6.7%, N-Ex =7.8%±5.0%). Heart rate (HR) estimated by the FBC2 was lower than estimated (Est) HR for pace based on HR extrapolation (FBC2 =155±18 bpm, Est =183±15 bpm, P<0.001). The difference in CFS and VO2max was inversely correlated with the difference in FBC2 HR and Estimated HR (r =-0.45, P<0.001). CONCLUSIONS The FBC2 shows consistent, unbiased measurement of CFS while overestimating VO2max in healthy men and women. The non-exercise VO2max prediction equation provides a similar, slightly more accurate, VO2max prediction than the CFS without the need for an exercise test or purchase of a Fitbit.
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Affiliation(s)
- Kaitlin A Freeberg
- Departments of Kinesiology and Biology, Point Loma Nazarene University, San Diego, CA, USA
| | - Brett R Baughman
- Departments of Kinesiology and Biology, Point Loma Nazarene University, San Diego, CA, USA
| | - Ted Vickey
- Departments of Kinesiology and Biology, Point Loma Nazarene University, San Diego, CA, USA
| | - Jeff A Sullivan
- Departments of Kinesiology and Biology, Point Loma Nazarene University, San Diego, CA, USA
| | - Brandon J Sawyer
- Departments of Kinesiology and Biology, Point Loma Nazarene University, San Diego, CA, USA
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