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Narendrula A, Brinza E, Horvat Davey C, Longenecker CT, Webel AR. Relationship between objectively measured physical activity and subclinical cardiovascular disease: a systematic review. BMJ Open Sport Exerc Med 2024; 10:e001596. [PMID: 38292295 PMCID: PMC10826575 DOI: 10.1136/bmjsem-2023-001596] [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] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
Introduction The association of physical activity (PA) with subclinical cardiovascular disease (CVD) is unclear. Clarifying this relationship may inform cardiovascular prevention strategies. Methods We performed a systematic review (CRD42021226089) using Medline, Embase, CINAHL and Cochrane (1 January 2000 to 1 September 2023). Studies published with adult populations exploring the relationship between objectively measured PA and subclinical CVD were included. Subclinical CVD was assessed using: ankle-brachial index (ABI); arterial stiffness; carotid artery disease; coronary artery atherosclerosis; endothelial function; and measures of cardiac structure and function. The Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) and Cochrane Risk of Bias tools were used for quality review. Results Of 68 included studies, most supported an inverse relationship between PA and subclinical CVD. Arterial stiffness was the most common outcome (n=40), and 33 studies suggested that less sedentary behaviour (SB), increased PA and/or higher intensity PA was associated with less arterial stiffness. Ten studies of carotid artery disease (total n=18), six of endothelial function (n=10), two of coronary artery disease (n=3) and all of ABI (n=6) suggested that PA or less SB is associated with less subclinical disease. Five studies assessing cardiac structure/function (n=6) suggested alterations in structure/function with PA. Conclusions PA reduces the risk of CVD events, and this systematic review demonstrates that some of the benefits may be mediated by an inverse association between PA and subclinical CVD. Interventions to increase PA are important for CVD prevention, so we provide a comprehensive overview of which surrogate outcome measures may be most useful to assess future CVD prevention interventions. PROSPERO registration number CRD42021226089.
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Affiliation(s)
- Aparna Narendrula
- Internal Medicine, NYU Grossman School of Medicine, New York, New York, USA
| | - Ellen Brinza
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Christine Horvat Davey
- Case Western Reserve University Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
| | - Chris T Longenecker
- Division of Cardiology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Allison R Webel
- University of Washington School of Nursing, Seattle, Washington, USA
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Ekblom-Bak E, Börjesson M, Ekblom Ö, Angerås O, Bergman F, Berntsson C, Carlhäll CJ, Engström G, Engvall J, Fagman E, Flinck A, Johansson P, Jujic A, Kero T, Lind L, Mannila M, Ostenfeld E, Persson A, Persson J, Persson M, Redfors B, Sandberg C, Wennberg P, Öhlin J, Östgren CJ, Jernberg T. Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis: cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study. BMJ Open 2023; 13:e073380. [PMID: 37996228 PMCID: PMC10668326 DOI: 10.1136/bmjopen-2023-073380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVES The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours. DESIGN Cross-sectional. SETTING Multisite study at university hospitals. PARTICIPANTS A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer. PRIMARY AND SECONDARY OUTCOMES Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound. RESULTS High daily SED (>70% ≈10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% ≈8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% ≈20 min/day, associated with lower OR for significant CA (OR range 0.61-0.67), CACS (OR range 0.71-0.75) and CarA (OR range 0.72-0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73). CONCLUSIONS MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.
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Affiliation(s)
- Elin Ekblom-Bak
- Department of Physical Activity and Health, Swedish School of Sport and Health Sciences GIH, Stockholm, Sweden
| | - Mats Börjesson
- Center for Health and Performance, University of Gothenburg, Goteborg, Sweden
- Institute of Medicine, University of Gothenburg, Goteborg, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, Swedish School of Sport and Health Sciences GIH, Stockholm, Sweden
| | - Oskar Angerås
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, Sweden
| | - Frida Bergman
- Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
| | - Caroline Berntsson
- Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden
- Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Goteborg, Sweden
| | - Carl-Johan Carlhäll
- Department of Health, Medicine and Caring Sciences and Department of Clinical Physiology, Linköping University, Linkoping, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Jan Engvall
- Department of Health, Medicine and Caring Sciences and Department of Clinical Physiology, Linköping University, Linkoping, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden
| | - Erika Fagman
- Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden
- Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Goteborg, Sweden
| | - Agneta Flinck
- Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden
- Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Goteborg, Sweden
| | - Peter Johansson
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Amra Jujic
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital Malmö, Malmo, Sweden
| | - Tanja Kero
- Medical Image Centre, Uppsala University Hospital, Uppsala, Sweden
- Department of Surgical Sciences and Radiology, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Maria Mannila
- Department of Cardiology and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Ellen Ostenfeld
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Clinical Physiology, Skåne University Hospital, Lund, Sweden
| | - Anders Persson
- Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
- Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Jonas Persson
- Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Internal Medicine, University Hospital, Malmö, Sweden
| | - Björn Redfors
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden
| | - Camilla Sandberg
- Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umea, Sweden
| | - Patrik Wennberg
- Public Health and Clinical Medicine, Family Medicine, Umeå University, Umea, Sweden
| | - Jerry Öhlin
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Carl Johan Östgren
- Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden
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Pae BJ, Lee SK, Kim S, Siddiquee AT, Hwang YH, Lee MH, Kim REY, Kim SH, Lee M, Shin C. Effect of physical activity on the change in carotid intima-media thickness: An 8-year prospective cohort study. PLoS One 2023; 18:e0287685. [PMID: 37352303 PMCID: PMC10289364 DOI: 10.1371/journal.pone.0287685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/09/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND AND AIMS There is a demand for longitudinal studies that use both objective and subjective measures of physical activity to investigate the association of physical activity with the change in carotid intima-media thickness (CIMT). In order to investigate such association, we conducted an 8-year follow-up study that used both objective and subjective measures of physical activity. METHODS This cohort study used subsamples of the ongoing Korean Genome and Epidemiology Study (KoGES). Included participants were between 49 to 79 years of age at baseline. Exclusion criteria included incomplete assessments of pedometer/accelerometer, international physical activity questionnaire (IPAQ), and baseline CIMT. Participants with a history of cardiovascular diseases were further excluded. Linear regression models were used for the main analysis. Age differences were assessed by stratifying the participants into < 60 years and ≥ 60 years. RESULTS After removing excluded participants, 835 participants were included in the final analysis (age, 59.84 ± 6.53 years; 326 (39.04%) males). 453 participants were < 60 years and 382 participants were ≥ 60 years. The daily total step count was inversely associated with the percent change in overall CIMT over 8-years (β = -0.015, standard error = 0.007, P = 0.034). This association was present among participants in the < 60-year-old group (β = -0.026, standard error = 0.010, P = 0.006), but not among participants in the ≥ 60-year-old group (β = -0.010, standard error = 0.011, P = 0.38). CONCLUSIONS The findings suggest that taking preemptive actions of increasing physical activity may prevent the incidence of atherosclerosis.
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Affiliation(s)
- Byung Joon Pae
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Seung Ku Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Soriul Kim
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ali T. Siddiquee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Yoon Ho Hwang
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Min-Hee Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
- Department of Pediatrics, Wayne State University School of Medicine, and the Translational Imaging Laboratory, Children’s Hospital of Michigan, Detroit, MI, United States of America
| | - Regina E. Y. Kim
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Seong Hwan Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Miyoung Lee
- College of Physical Education and Sport Science, Kookmin University, Seoul, Republic of Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
- Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
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Kumar A, Qiao Y, Wasserman B, Gabriel KP, Martinez-Amezcua P, Dooley EE, Diaz KM, Evenson KR, Sharrett AR, Zhang Y, Palta P. Association of leisure-time physical activity and sedentary behavior with carotid atherosclerosis morphology: The ARIC carotid-MRI study. Am J Prev Cardiol 2023; 14:100505. [PMID: 37252440 PMCID: PMC10220308 DOI: 10.1016/j.ajpc.2023.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023] Open
Abstract
Objective We evaluated the prospective association of midlife leisure-time physical activity (LTPA) and sedentary behavior (SB), and their temporal patterns, with MRI-measured carotid atherosclerotic morphology. Methods Participants enrolled in the Carotid MRI substudy (2004-2006) of the Atherosclerosis Risk in Communities (ARIC) Study and with self-reported assessments of LTPA and SB at visits 1 (1987-1989) and 3 (1993-1995) were included in this study. LTPA was ascertained using the ARIC/Baecke physical activity questionnaire and categorized according to the American Heart Association's metric of poor, intermediate, or ideal physical activity. SB, measured as TV viewing frequency, was categorized as high, medium, and low. We used multivariable adjusted linear and logistic regression models to examine the associations between midlife (visit 3 only) and persistent (visit 1 to 3) LTPA and TV viewing with carotid artery plaque burden and components. Results Among the 1,582 (mean age: 59 years, 43% male, 18% Black) participants, 45.7%, 21.7%, and 32.6% reported ideal, intermediate, or poor LTPA, respectively. High TV viewing was reported in 33.8% of participants, with 46.4% and 19.8% reporting medium or low TV viewing, respectively. Compared to poor LTPA, ideal LTPA in midlife was not associated with total wall volume (ß=0.01, 95% CI: -0.01, 0.03), maximum carotid wall thickness (ß=0.06, 95% CI: -0.08, 0.21), normalized wall index (ß=-0.01, 95% CI: -0.03, 0.01), or maximum stenosis (ß=-0.11, 95% CI: -1.98, 1.76). Low or middle, compared to high, TV viewing was also not associated with carotid artery measures of plaque burden. Compared to poor LTPA or high TV viewing, ideal LTPA (odds ratio (OR): 0.82, 95% CI: 0.55, 1.23) and low TV viewing (OR=0.90, 95% CI: 0.56, 1.44) was not associated with odds of lipid core presence, respectively. Conclusion Overall, this study does not provide strong evidence for an association between LTPA and SB with carotid plaque measures.
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Affiliation(s)
- Aarti Kumar
- Columbia University Vagelos College of Physicians and Surgeons, United States
| | - Ye Qiao
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States
| | - Bruce Wasserman
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Erin E. Dooley
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Keith M. Diaz
- Center for Cardiovascular and Behavioral Health, Columbia University Irving Medical Center, New York, NY, United States
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Yiyi Zhang
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
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Yang D, Liu M, Willey JZ, Khasiyev F, Tom SE, Rundek T, Cheung YK, Wright CB, Sacco RL, Elkind MSV, Gutierrez J. Physical Activity Is Inversely Associated With Severe Intracranial Stenosis in Stroke-Free Participants of NOMAS. Stroke 2023; 54:159-166. [PMID: 36416126 PMCID: PMC9780184 DOI: 10.1161/strokeaha.122.039660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although protective in secondary stroke prevention of intracranial arterial stenosis (ICAS), it is uncertain if the benefits of leisure time physical activity (LTPA) extend to asymptomatic ICAS or extracranial carotid stenosis (ECAS). Therefore, we sought to determine LTPA's relationship with ECAS and ICAS in a stroke-free, race-ethnically diverse cohort. METHODS This cross-sectional study included participants from the magnetic resonance imaging substudy of the Northern Manhattan Study, of whom 1274 had LTPA assessments at enrollment. LTPA was represented continuously as metabolic equivalent score (MET-score) and ordinally as model-based cluster analysis (LTPA-cluster), both based on the same LTPA assessments. We evaluated ECAS sonographically using carotid intima-media thickening and number of carotid plaques. ICAS was assessed with time-of-flight magnetic resonance angiograph and defined as ≥50% or ≥70% stenosis. We applied regression analyses to evaluate the association between LTPA with ECAS and ICAS, adjusting for confounders. RESULTS Of 1274 included participants (mean age 71±9 years; 60% women; 65% Hispanic), the mean MET-score was 10±16 and 60% were in a LTPA-cluster with any activity. Among those with carotid ultrasound (n=1234), the mean carotid intima-media thickening was 0.97±0.09 mm, and 56% of participants had at least one carotid plaque identified. Among those with magnetic resonance angiograph (n=1211), 8% had ≥50% ICAS and 5% had ≥70% ICAS. For ICAS, MET-score was associated with ≥70% ICAS (adjusted odds ratio per unit increase in MET-score [95% CI, 0.97 [0.94-0.99]) but not with ECAS measures (carotid intima-media thickening, adjusted β-estimate per unit increase in MET-score [95% CI], 0.002 [-0.003 to 0.006] or number of plaques, adjusted β-estimate [95% CI], 0.0001 [-0.0001 to 0.0003]). Substituting MET-score with LTPA-clusters replicated the association between ≥70% ICAS and LTPA (adjusted odds ratio per each increased LTPA-cluster [95% CI], 0.83 [0.70-0.99]). CONCLUSIONS In this diverse stroke-free population, we found LTPA most strongly associated with asymptomatic ≥70% ICAS. Given the high-risk nature of ≥70% ICAS, these findings may emphasize the role of LTPA in people at risk for ICAS.
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Affiliation(s)
- Dixon Yang
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Minghua Liu
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Joshua Z Willey
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Farid Khasiyev
- Department of Neurology, Saint Louis University, Saint Louis, MO, USA
| | - Sarah E Tom
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ying K Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Clinton B Wright
- National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Daniele A, Lucas SJE, Rendeiro C. Detrimental effects of physical inactivity on peripheral and brain vasculature in humans: Insights into mechanisms, long-term health consequences and protective strategies. Front Physiol 2022; 13:998380. [PMID: 36237532 PMCID: PMC9553009 DOI: 10.3389/fphys.2022.998380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
The growing prevalence of physical inactivity in the population highlights the urgent need for a more comprehensive understanding of how sedentary behaviour affects health, the mechanisms involved and what strategies are effective in counteracting its negative effects. Physical inactivity is an independent risk factor for different pathologies including atherosclerosis, hypertension and cardiovascular disease. It is known to progressively lead to reduced life expectancy and quality of life, and it is the fourth leading risk factor for mortality worldwide. Recent evidence indicates that uninterrupted prolonged sitting and short-term inactivity periods impair endothelial function (measured by flow-mediated dilation) and induce arterial structural alterations, predominantly in the lower body vasculature. Similar effects may occur in the cerebral vasculature, with recent evidence showing impairments in cerebral blood flow following prolonged sitting. The precise molecular and physiological mechanisms underlying inactivity-induced vascular dysfunction in humans are yet to be fully established, although evidence to date indicates that it may involve modulation of shear stress, inflammatory and vascular biomarkers. Despite the steady increase in sedentarism in our societies, only a few intervention strategies have been investigated for their efficacy in counteracting the associated vascular impairments. The current review provides a comprehensive overview of the evidence linking acute and short-term physical inactivity to detrimental effects on peripheral, central and cerebral vascular health in humans. We further examine the underlying molecular and physiological mechanisms and attempt to link these to long-term consequences for cardiovascular health. Finally, we summarize and discuss the efficacy of lifestyle interventions in offsetting the negative consequences of physical inactivity.
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Affiliation(s)
- Alessio Daniele
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Catarina Rendeiro,
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Chen L, Bi Y, Su J, Cui L, Han R, Tao R, Zhou J, Wu M, Qin Y. Physical activity and carotid atherosclerosis risk reduction in population with high risk for cardiovascular diseases: a cross-sectional study. BMC Public Health 2022; 22:250. [PMID: 35130854 PMCID: PMC8822633 DOI: 10.1186/s12889-022-12582-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Decreased physical activity had been reported to be a common causal and modifiable risk factor for major vascular events. However, the relationship of physical activity and sedentary leisure time with carotid atherosclerosis in population with high risk for cardiovascular diseases (CVDs) is still inconclusive. We aimed to evaluate the association of physical activity and sedentary leisure time with the risk of carotid atherosclerosis, and investigate any possible effect modifiers in population with high risk for CVDs. Methods
The study population was drawn from the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project-Jiangsu project, which is a population-based screening project that included permanent residents aged 35-75 years from 6 surveillance cities in Jiangsu Province. Linear regression models were used to evaluate the association of physical activity and sedentary leisure time with carotid intima-media thickness (CIMT). The risks of abnormal carotid artery and carotid plaque (CP) were estimated by odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. Results Overall, a total of 10,920 participants were enrolled in the final analysis. There was a significant inverse association of physical activity level with CIMT (per SD increase: β=-0.0103; 95%CI: -0.0154, -0.0053). The risk of abnormal carotid artery and CP decreased significantly with the increase of physical activity level (per SD increase: OR=0.908, 95%CI: 0.869-0.948; OR=0.900, 95%CI: 0.857-0.945, respectively). When physical activity level was categorized as quartiles, a significantly lower risk of abnormal carotid artery and CP was found in quartiles 2-4 with quartile 1 as reference (P<0.05 for all). Furthermore, the inverse association were stronger in participants with age ≥60 years (vs. <60 years, Pinteraction<0.001 for both). However, there were no significant association of sedentary leisure time with CIMT, abnormal carotid artery and CP. Conclusions In population with high risk for CVDs, physical activity was inversely associated with CIMT, abnormal carotid artery and CP, particularly among the elders. Sedentary leisure time was not associated with them. These results suggested that physical activity is important for carotid vascular health, and perhaps especially in elder population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12582-6.
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Affiliation(s)
- Lulu Chen
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuan Bi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Shanghai Municipal Center for Health Promotion, Shanghai, China
| | - Jian Su
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Lan Cui
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Renqiang Han
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ran Tao
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ming Wu
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yu Qin
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
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Aho S, Vuoristo MS, Raitanen J, Mansikkamäki K, Alanko J, Vähä-Ypyä H, Luoto R, Kellokumpu-Lehtinen PL, Vasankari T. Higher number of steps and breaks during sedentary behaviour are associated with better lipid profiles. BMC Public Health 2021; 21:629. [PMID: 33789632 PMCID: PMC8010961 DOI: 10.1186/s12889-021-10656-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) is known to be associated with lipid profiles and the risk of both cardiovascular diseases and cancer. The aim of this study was to evaluate the association of objectively measured PA, sedentary behaviour (SB), amount of breaks during SB and number of daily steps with serum lipids in a healthy, Finnish, middle-aged, female population. METHODS The participants (571) were recruited at mammography screening, target group was women aged 50-60 years. A measurement of PA was done with accelerometer, blood lipid profile was assessed, and questionnaires of participants characteristics were sent to participants. RESULTS The participants with the highest number of daily breaks during SB (≥ 41) had the highest mean concentration of HDL-cholesterol (high density lipoprotein cholesterol, HDL-c) (1.9 mmol/l, standard deviation (SD) 0.4) and the lowest mean concentration of triglycerides (1.0 mmol/l, SD 0.5). HDL-c level was 0.16 mmol/l higher (p < 0.001) in the group with 28-40.9 breaks/day and 0.25 mmol/l higher (p < 0.001) among participants with ≥41 breaks/day than in the group with the fewest breaks during SB (< 28). Those with the most daily steps (≥ 9100) had the highest mean HDL-c level (1.9 mmol/l). HDL-c level was 0.16 mmol/l higher (p < 0.001) among the participants with 5600-9099 steps/day and 0.26 mmol/l higher (p < 0.001) among participants with ≥9100 steps/day than those with the fewest steps (< 5600). The number of daily steps was inversely associated with the triglyceride concentration. From wake-time, participants spent 60% in SB, 18% standing, 14% in light PA, and 9% in moderate-to-vigorous PA (MVPA). PA was associated with serum total cholesterol (TC), HDL-c and triglyceride levels. The mean HDL-c level was the highest in the lowest quartile of SB and in the highest quartile of MVPA. CONCLUSIONS To our knowledge, this is the first study showing a high number of objectively measured breaks during SB is associated with a favourable effect on the level of serum lipids, which may later translate into cardiovascular health among middle-aged women. TRIAL REGISTRATION This study was registered and approved by the Regional Ethics Committee of Tampere University Hospital in Finland (approval code R15137 ).
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Affiliation(s)
- Sonja Aho
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland. .,Department of Oncology, Tampere University Hospital, P. O. Box 2000, 33521, Tampere, Finland.
| | - Meri-Sisko Vuoristo
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland.,Department of Oncology, Tampere University Hospital, P. O. Box 2000, 33521, Tampere, Finland
| | - Jani Raitanen
- The UKK Institute for Health Promotion Research, Tampere, Finland.,Tampere University, Faculty of Social Sciences (Health Sciences), Tampere, Finland
| | - Kirsi Mansikkamäki
- Tampere University of Applied Sciences, Biomedical Laboratory Science, Tampere, Finland
| | - Johanna Alanko
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Riitta Luoto
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland.,Tampere University Hospital, Research, Development and Innovation Center, Tampere, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland.,Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
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Frigerio B, Werba JP, Amato M, Ravani A, Sansaro D, Coggi D, Vigo L, Tremoli E, Baldassarre D. Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials. Curr Pharm Des 2020; 26:11-24. [PMID: 31838990 DOI: 10.2174/1381612825666191213120339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/02/2019] [Indexed: 12/24/2022]
Abstract
In the present review, associations between traditional vascular risk factors (VRFs) and carotid intimamedial thickness progression (C-IMTp) as well as the effects of therapies for VRFs control on C-IMTp were appraised to infer causality between each VRF and C-IMTp. Cohort studies indicate that smoking, binge drinking, fatness, diabetes, hypertension and hypercholesterolemia are associated with accelerated C-IMTp. An exception is physical activity, with mixed data. Interventions for the control of obesity, diabetes, hypertension and hypercholesterolemia decelerate C-IMTp. Conversely, scarce information is available regarding the effect of smoking cessation, stop of excessive alcohol intake and management of the metabolic syndrome. Altogether, these data support a causative role of several traditional VRFs on C-IMTp. Shortcomings in study design and/or ultrasonographic protocols may account for most negative studies, which underlines the importance of careful consideration of methodological aspects in investigations using C-IMTp as the outcome.
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Affiliation(s)
| | - José P Werba
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | | | - Daniela Coggi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita di Milano, Milan, Italy
| | - Lorenzo Vigo
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Elena Tremoli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita di Milano, Milan, Italy
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Medical Biotechnology and Translational Medicine, Università di Milano, Milan, Italy
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10
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Predictors for progressions of brachial-ankle pulse wave velocity and carotid intima-media thickness over a 12-year follow-up: Hanzhong Adolescent Hypertension Study. J Hypertens 2020; 37:1167-1175. [PMID: 31026243 PMCID: PMC6513272 DOI: 10.1097/hjh.0000000000002020] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: Atherosclerotic diseases are the leading cause of death worldwide. This study aimed to investigate the predictors of brachial–ankle pulse wave velocity (baPWV) and carotid intima–media thickness (CIMT) progression in a Chinese cohort over a 12-year follow-up period and to determine whether these predictors differ by follow-up time. Methods: A total of 202 participants were recruited from a previously established cohort in Shaanxi Province, China. Both baPWV and CIMT were measured in 2013 and 2017. Multivariable regression was used to determine the predictors of CIMT and baPWV progression. Results: Men had higher CIMT and baPWV and a higher rate of CIMT progression during two follow-ups than women. A 4-year change in SBP was associated with baPWV progression, whereas a 12-year change in DBP was associated with baPWV progression. The increased progression of baPWV presented a linear trend when subgrouping all the participants according to SBP and DBP changes over 4 and 12 years, respectively. In addition, heart rate (HR) change over 4 and 12 years was consistently associated with CIMT progression, and a linear trend was also seen when subgrouping the population. Conclusion: Our study demonstrated that SBP and DBP contributed differently in different stages to the progression of arterial stiffness in this Chinese cohort. Moreover, HR was consistently involved in the increased progression of CIMT in all periods. These findings underline the importance of early detection and control of blood pressure and resting HR for the prevention of arterial stiffness progression.
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11
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Physical Activity Intervention Effects on Sedentary Time in Spanish-Speaking Latinas. J Phys Act Health 2020; 17:343-348. [PMID: 32035412 DOI: 10.1123/jpah.2019-0112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 11/13/2019] [Accepted: 12/09/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Latinas have high rates of sedentary behavior and related health disparities, but it is unknown if interventions to increase physical activity will also reduce sedentary time. The current study examined changes in objectively measured sedentary time among Latinas in a randomized controlled trial of a physical activity intervention. METHODS Spanish-speaking Latinas (N = 202) were randomized to an exercise or wellness group and wore an accelerometer at baseline, 6 months, and 12 months. RESULTS Participants were sedentary on an average of 8.86 hours per day (SD = 2.60) at baseline. The intervention group had significantly greater increases in sedentary time compared with the control group, with the intervention group engaging in 146 more minutes per week of sedentary time at 6 months and 254 minutes per week of sedentary time at 12 months than the control group (P = .02). The intervention effect on sedentary behavior remained after controlling for moderate to vigorous physical activity. Additionally, time spent in moderate to vigorous physical activity was positively associated with more sedentary time (P = .04). CONCLUSION An intervention to increase moderate to vigorous physical activity resulted in greater sedentary time, raising concerns regarding compensation and highlighting the need for interventions to address both physical activity and sedentary behavior to improve public health.
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12
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Ji X, Leng XY, Dong Y, Ma YH, Xu W, Cao XP, Hou XH, Dong Q, Tan L, Yu JT. Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:632. [PMID: 31930033 DOI: 10.21037/atm.2019.10.115] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Carotid atherosclerosis is a major cause of stroke, but the conclusion about risk factors for carotid atherosclerosis is still controversial. The aim of our present meta-analysis and systematic review was to explore the modifiable risk factors for carotid atherosclerosis. Methods We searched PubMed from January 1962 to October 2018 to include longitudinal and cross-sectional studies. The results were pooled using random effects model. Heterogeneity was measured by I2 statistic and publication bias was assessed by funnel plots. Results A total of 14,700 articles were screened, of which 76 with 27 factors were eligible. Our meta-analysis of cross-sectional studies indicated nine factors (hyperlipidemia, hyperhomocysteinemia, hypertension, hyperuricemia, smoking, metabolic syndrome, hypertriglyceridemia, diabetes, and higher low density lipoprotein) were significantly associated with the presence of carotid plaque, among which four (hyperlipidemia, hyperhomocysteinemia, hypertension, and hyperuricemia) could elevate the risk of atherosclerosis by at least 50%; and one factor (hypertension) was associated with increased carotid intima-media thickness. In the systematic review, another five factors [negative emotion, socioeconomic strain, alcohol, air pollution, and obstructive sleep apnea syndrome (OSAS)] were also related to the presence of atherosclerosis. The cross-sectional associations with most of the above 14 factors were further confirmed by longitudinal studies. Among them, the managements of 4 factors (hypertension, hyperlipidemia, diabetes and OSAS) were indicated to prevent carotid atherosclerosis by cohort studies. Conclusions Effective interventions targeting pre-existing disease, negative emotion, lifestyle and diet may reduce the risk of carotid atherosclerosis. Further good-quality prospective studies are needed to confirm these findings.
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Affiliation(s)
- Xi Ji
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian 116044, China.,Department of Neurology, Xuchang People's Hospital, Xuchang 461000, China
| | - Xin-Yi Leng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Yi Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian 116044, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Xi-Peng Cao
- Clinical Research Center, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Xiao-He Hou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian 116044, China.,Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
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13
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Mañas A, Del Pozo-Cruz B, Rodríguez-Gómez I, Leal-Martín J, Losa-Reyna J, Rodríguez-Mañas L, García-García FJ, Ara I. Dose-response association between physical activity and sedentary time categories on ageing biomarkers. BMC Geriatr 2019; 19:270. [PMID: 31615446 PMCID: PMC6794876 DOI: 10.1186/s12877-019-1284-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022] Open
Abstract
Background Physical activity and sedentary behaviour have been suggested to independently affect a number of health outcomes. To what extent different combinations of physical activity and sedentary behaviour may influence physical function and frailty outcomes in older adults is unknown. The aim of this study was to examine the combination of mutually exclusive categories of accelerometer-measured physical activity and sedentary time on physical function and frailty in older adults. Methods 771 older adults (54% women; 76.8 ± 4.9 years) from the Toledo Study for Healthy Aging participated in this cross-sectional study. Physical activity and sedentary time were measured by accelerometry. Physically active was defined as meeting current aerobic guidelines for older adults proposed by the World Health Organization. Low sedentary was defined as residing in the lowest quartile of the light physical activity-to-sedentary time ratio. Participants were then classified into one of four mutually exclusive movement patterns: (1) ‘physically active & low sedentary’, (2) ‘physically active & high sedentary’, (3) ‘physically inactive & low sedentary’, and (4) ‘physically inactive & high sedentary’. The Short Physical Performance Battery was used to measure physical function and frailty was assessed using the Frailty Trait Scale. Results ‘Physically active & low sedentary’ and ‘physically active & high sedentary’ individuals had significantly higher levels of physical function (β = 1.73 and β = 1.30 respectively; all p < 0.001) and lower frailty (β = − 13.96 and β = − 8.71 respectively; all p < 0.001) compared to ‘physically inactive & high sedentary’ participants. Likewise, ‘physically inactive & low sedentary’ group had significantly lower frailty (β = − 2.50; p = 0.05), but significance was not reached for physical function. Conclusions We found a dose-response association of the different movement patterns analysed in this study with physical function and frailty. Meeting the physical activity guidelines was associated with the most beneficial physical function and frailty profiles in our sample. Among inactive people, more light intensity relative to sedentary time was associated with better frailty status. These results point out to the possibility of stepwise interventions (i.e. targeting less strenuous activities) to promote successful aging, particularly in inactive older adults.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja Del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Javier Leal-Martín
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain. .,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
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14
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Lazaros G, Oikonomou E, Vogiatzi G, Christoforatou E, Tsalamandris S, Goliopoulou A, Tousouli M, Mystakidou V, Chasikidis C, Tousoulis D. The impact of sedentary behavior patterns on carotid atherosclerotic burden: Implications from the Corinthia epidemiological study. Atherosclerosis 2019; 282:154-161. [DOI: 10.1016/j.atherosclerosis.2019.01.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/27/2018] [Accepted: 01/15/2019] [Indexed: 02/07/2023]
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15
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Walker TJ, Heredia NI, Lee M, Laing ST, Fisher-Hoch SP, McCormick JB, Reininger BM. The combined effect of physical activity and sedentary behavior on subclinical atherosclerosis: a cross-sectional study among Mexican Americans. BMC Public Health 2019; 19:161. [PMID: 30727990 PMCID: PMC6366018 DOI: 10.1186/s12889-019-6439-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity and sedentary behavior are considered independent risk factors for chronic disease. However, we do not fully understand their interrelation with key health outcomes such as subclinical atherosclerosis. This study examines the combined effects of sedentary behavior and physical activity on carotid intima-media thickness (cIMT) and presence of carotid plaque in a Mexican American population on the Texas-Mexico border. METHODS This cross-sectional study was conducted using retrospective data from a sample (n = 612) of participants from the Cameron County Hispanic Cohort. Carotid ultrasound was used to measure cIMT and presence of carotid plaque. Self-reported questionnaires were used to assess leisure time physical activity and sedentary behavior (TV/movie sitting and total sitting). A series of multivariable regression models were used to assess study aims. An interaction term between physical activity and sedentary behavior was included in models for each respective outcome. Models were controlled for demographic and health-related variables. RESULTS There were no significant associations found between physical activity, sedentary behavior and mean cIMT, or cIMT thickness ≥ 75th percentile for age and gender. However, there was a significant interaction between physical activity and TV/movie sitting with presence of carotid plaque. Participants who reported moderate levels of physical activity had significantly lower odds for presence of plaque compared to participants with no activity when TV/movie sitting time was ≤3 h per day. However, there was no significant difference in odds for presence of plaque between physical activity groups when TV/movie sitting exceeded 3 h/day. These results were consistent with models examining total sitting time. CONCLUSIONS Our results indicate that for Mexican Americans, there is a combined effect of sedentary behavior and physical activity on presence of carotid plaque. Participating in moderate physical activity is optimal for having lower levels of carotid plaque in addition to avoiding excessive levels of TV/movie sitting (≥3 h/day) and/or total sitting (≥8.5 h/day).
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Affiliation(s)
- Timothy J. Walker
- Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin St, Houston, TX 77030 USA
| | - Natalia I. Heredia
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Houston, TX 77030 USA
| | - MinJae Lee
- Division of Clinical and Translational Sciences, Department of Internal Medicine, The University of Texas McGovern Medical School; Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin St, Houston, TX 77030 USA
| | - Susan T. Laing
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX 77030 USA
| | - Susan P. Fisher-Hoch
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Brownsville Regional Campus, 1 W University Blvd, Brownsville, TX 78520 USA
| | - Joseph B. McCormick
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Brownsville Regional Campus, 1 W University Blvd, Brownsville, TX 78520 USA
| | - Belinda M. Reininger
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Brownsville Regional Campus, 1 W University Blvd, Brownsville, TX 78520 USA
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Stoičkov V, Šarić S, Andonov S, Kostić S, Lović M, Sekulović M. THE INFLUENCE OF EXERCISE TRAINING ON QT DISPERSION AND RISK FACTORS FOR CAR DIOVASCULAR DISEASES IN PATIENTS AFTER CORONARY ARTERY BYPASS GRAFT SURGE RY. ACTA MEDICA MEDIANAE 2018. [DOI: 10.5633/amm.2018.0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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Vasankari V, Husu P, Vähä-Ypyä H, Suni JH, Tokola K, Borodulin K, Wennman H, Halonen J, Hartikainen J, Sievänen H, Vasankari T. Subjects with cardiovascular disease or high disease risk are more sedentary and less active than their healthy peers. BMJ Open Sport Exerc Med 2018; 4:e000363. [PMID: 29765701 PMCID: PMC5950643 DOI: 10.1136/bmjsem-2018-000363] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 01/10/2023] Open
Abstract
Objectives We investigated differences in objectively measured sedentary behaviour (SB) and physical activity (PA) levels in subjects with cardiovascular disease (CVD) diagnosis or high CVD risk compared with healthy controls. Methods The present study includes a subsample (n=1398, Health 2011 Study) of participants, who attended health examinations and wore a triaxial accelerometer (≥4 days). Patients with CVD were identified and CVD risk was calculated for others using Framingham Risk Score (FRS). Participants were categorised into groups: FRS<10%; FRS=10%–30%; FRS>30%/CVD. Raw acceleration data were analysed with mean amplitude deviation (MAD) and angle for posture estimation (APE). MAD corresponding to intensity of PA was converted to metabolic equivalents (MET) and categorised to light (1.5–2.9 METs) and moderate to vigorous PA (MVPA≥3.0 METs). APE recognises SB and standing. Results Daily accumulated time of >30 s MVPA bouts was higher in FRS<10% group (46 min) than in FRS>30%/CVD group (29 min) (p<0.001). FRS>30%/CVD group were more sedentary, their mean daily number of >10 min SB bouts (13.2) was higher than in FRS <10% group (11.5) (p=0.002). Conclusion Number and accumulated times of SB and PA bouts differed between the CVD risk groups. Causative research is required to assess the importance of SB and PA in prevention and rehabilitation of CVDs.
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Affiliation(s)
- Ville Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland.,Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland.,The University of Eastern Finland (UEF), Kuopio, Finland
| | - Pauliina Husu
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | | | - Kari Tokola
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Katja Borodulin
- The National Institute of Health and Welfare (THL), Helsinki, Finland
| | - Heini Wennman
- The National Institute of Health and Welfare (THL), Helsinki, Finland
| | - Jari Halonen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland.,The University of Eastern Finland (UEF), Kuopio, Finland
| | - Juha Hartikainen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland.,The University of Eastern Finland (UEF), Kuopio, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland
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Carter S, Hartman Y, Holder S, Thijssen DH, Hopkins ND. Sedentary Behavior and Cardiovascular Disease Risk: Mediating Mechanisms. Exerc Sport Sci Rev 2017; 45:80-86. [PMID: 28118158 DOI: 10.1249/jes.0000000000000106] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sedentary behavior has a strong association with cardiovascular disease (CVD) risk, which may be independent of physical activity. To date, the mechanism(s) that mediate this relationship are poorly understood. We hypothesize that sedentary behavior modifies key hemodynamic, inflammatory, and metabolic processes resulting in impaired arterial health. Subsequently, these vascular impairments directly and indirectly contribute to the development of CVD.
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Affiliation(s)
- Sophie Carter
- 1Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, United Kingdom; and 2Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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19
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Boss HM, van der Graaf Y, Visseren FLJ, Van den Berg-Vos RM, Bots ML, de Borst GJ, Cramer MJ, Kappelle LJ, Geerlings MI. Physical Activity and Characteristics of the Carotid Artery Wall in High-Risk Patients-The SMART (Second Manifestations of Arterial Disease) Study. J Am Heart Assoc 2017; 6:JAHA.116.005143. [PMID: 28736388 PMCID: PMC5586269 DOI: 10.1161/jaha.116.005143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Physical activity reduces the risk of vascular disease. This benefit is not entirely explained through an effect on vascular risk factors. We examined the relationship of physical activity and characteristics of the carotid artery wall in patients with vascular disease or risk factors. Methods and Results Cross‐sectional analyses were performed in 9578 patients from the SMART (Second Manifestations of Arterial Disease) study, a prospective cohort study among patients with vascular disease or risk factors. Physical activity was assessed using questionnaires. Carotid intima‐media thickness and carotid artery stenosis of both common carotid arteries was measured. In a subset of 3165 participants carotid diastolic diameter and distension were assessed. Carotid stiffness was expressed as the distensibility coefficient and Young's elastic modulus. Regression analyses adjusted for vascular risk factors showed that physical activity was inversely associated with diastolic diameter (fifth versus first quintile B=−0.13 mm; 95% CI, −0.21 to −0.05) and decreased risk of carotid artery stenosis (relative risk, 0.58; 95% CI, 0.48–0.69). A light level of physical activity was associated with less carotid stiffness (second versus first quintile; Young's elastic modulus B=−0.11 kPa−1×10−3; 95% CI, −0.16 to −0.06; distensibility coefficient B=0.93 kPa×103; 95% CI, 0.34–1.51), but there was no additional benefit with increasing levels of physical activity. In patients with vascular disease, physical activity was inversely associated with common carotid intima‐media thickness, but not in patients with vascular risk factors. Conclusions In patients with vascular disease or risk factors, increased physical activity was associated with smaller carotid diastolic diameter, decreased risk of carotid artery stenosis, and less carotid stiffness, but it only showed benefits on carotid intima‐media thickness in patients with vascular disease.
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Affiliation(s)
- H Myrthe Boss
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Neurology, OLVG West, Amsterdam, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gert Jan de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten J Cramer
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L Jaap Kappelle
- Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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20
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Vasankari V, Husu P, Vähä-Ypyä H, Suni J, Tokola K, Halonen J, Hartikainen J, Sievänen H, Vasankari T. Association of objectively measured sedentary behaviour and physical activity with cardiovascular disease risk. Eur J Prev Cardiol 2017; 24:1311-1318. [PMID: 28530126 DOI: 10.1177/2047487317711048] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background We evaluated the association of accelerometer-based sedentary behaviour and physical activity with the risk of cardiovascular disease. Design The design of this study used a population-based, cross-sectional sample. Methods A subsample of participants in the Health 2011 Study in Finland used the tri-axial accelerometer (≥4 days, >10 h/day, n = 1398). Sedentary behaviour (sitting, lying) and standing still in six-second epochs were recognised from raw acceleration data based on intensity and device orientation. The intensity of physical activity was calculated as one-minute moving averages of mean amplitude deviation of resultant acceleration and converted to metabolic equivalents. Metabolic equivalents were categorised to light physical activity (1.5-2.9 metabolic equivalents) and moderate-to-vigorous physical activity (moderate-to-vigorous physical activity≥3.0 metabolic equivalents). Daily sedentary behaviour, standing still, light physical activity and moderate-to-vigorous physical activity were expressed as mean daily total time, accumulated time and number of different bouts (from 30 s to >30 min), mean daily metabolic equivalent and weekly peak metabolic equivalent levels of different bout lengths and number of breaks in sedentary behaviour. The ten-year cardiovascular disease risk was based on the Framingham risk model. Results The mean number of daily sedentary behaviour bouts was more strongly associated with cardiovascular disease risk than mean daily total time. In the best model, smaller waist circumference, greater value of mean daily metabolic equivalent levels of one-minute bouts, higher accumulated time of moderate-to-vigorous physical activity lasting ≤30 min, higher number of >5 min standing bouts and a higher number of long (>30 min) bouts of light physical activity were significantly associated with lower cardiovascular disease risk (R2 = 0.836). Conclusions The objectively measured number and accumulated time from different bout lengths of physical activity and sedentary behaviour were associated with cardiovascular disease risk, which is considered relevant for estimating cardiovascular diseases and for devising preventive actions.
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Affiliation(s)
- Ville Vasankari
- 1 The UKK Institute for Health Promotion Research, Finland.,2 Heart Center, Kuopio University Hospital (KUH), Finland.,3 University of Eastern Finland (UEF), Finland
| | - Pauliina Husu
- 1 The UKK Institute for Health Promotion Research, Finland
| | | | - Jaana Suni
- 1 The UKK Institute for Health Promotion Research, Finland
| | - Kari Tokola
- 1 The UKK Institute for Health Promotion Research, Finland
| | - Jari Halonen
- 2 Heart Center, Kuopio University Hospital (KUH), Finland.,3 University of Eastern Finland (UEF), Finland
| | - Juha Hartikainen
- 2 Heart Center, Kuopio University Hospital (KUH), Finland.,3 University of Eastern Finland (UEF), Finland
| | - Harri Sievänen
- 1 The UKK Institute for Health Promotion Research, Finland
| | - Tommi Vasankari
- 1 The UKK Institute for Health Promotion Research, Finland.,4 The National Institute for Health and Welfare (THL), Finland
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21
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Mazidi M, Vadadian P, Rezaie P, Azarpazhooh MR, Esmaeili H, Ghayour-Mobarhan M, Kengne AP, Ferns GA. Levels of physical activity are correlated with intima media ratio in subjects without but not with metabolic syndrome: A study of Iranians without a history of cardiovascular events. Diabetes Metab Syndr 2017; 11:99-102. [PMID: 27697535 DOI: 10.1016/j.dsx.2016.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
AIM We aimed to investigate the relationship between carotid Intima Media Thickness (CIMT) and physical activity levels (PAL), in subjects with and without metabolic syndrome (MetS) and in indidiviuals with and without carotid artery plaque (CAP) defined using high-resolution ultrasound. METHOD A sample of 506 subjects [215 (42.5%) males], aged 35-64 years was recruited from an urban population in Mashhad, Iran, using a stratified-cluster method as part of the Mashhad Stroke Heart Atherosclerosis Disorder (MASHAD) study cohort. This sub-sample was selected randomly from a cohort of 9765 individuals for carotid duplex ultrasound. Comparisons were made between individuals with and without CAP on the one hand, and between participants with and without MetS on the other hand with regard to physical activity and cardiometabolic risk level, as well as their correlation with CIMT. RESULT PAL was positively and significantly correlated with CIMT in the total sample (r=0.132, p<0.001). The correlation coefficient was 0.132 (p=0.426) in the MetS+ participants and 0.440 (p<0.001) in the MetS- participants. The correlation of PAL with CIMT was also positive and significant in CAP+ participants (r=0.150, p<0.001), but not in the CAP- participants (r=-0.001, p=0.621), with however a non-significant difference between the two estimates (p=0.374). Hip circumference was correlated with CIMT in MetS- but not MetS+ participants. CONCLUSION physical activity in the current study appeared to be a correlate of infraclinical CVD risk in participants without metabolic syndrome, but not in those without.
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Affiliation(s)
- Mohsen Mazidi
- Institute of Genetics and Developmental Biology. International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China; Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China
| | - Peymane Vadadian
- Cardiovascular Research centre, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Peyman Rezaie
- Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahmoud Reza Azarpazhooh
- Cardiovascular Research centre, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Habib Esmaeili
- Department of Statistics, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
| | - Andre Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Rm 342, Mayfield House, University of Brighton, BN1 9PH, UK
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22
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Wing JJ, August E, Adar SD, Dannenberg AL, Hajat A, Sánchez BN, Stein JH, Tattersall MC, Diez Roux AV. Change in Neighborhood Characteristics and Change in Coronary Artery Calcium: A Longitudinal Investigation in the MESA (Multi-Ethnic Study of Atherosclerosis) Cohort. Circulation 2016; 134:504-13. [PMID: 27528645 DOI: 10.1161/circulationaha.115.020534] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 07/11/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although some evidence shows that neighborhood deprivation is associated with greater subclinical atherosclerosis, prior studies have not identified what aspects of deprived neighborhoods were driving the association. METHODS We investigated whether social and physical neighborhood characteristics are related to the progression of subclinical atherosclerosis in 5950 adult participants of the MESA (Multi-Ethnic Study of Atherosclerosis) during a 12-year follow-up period. We assessed subclinical disease using coronary artery calcium (CAC). Neighborhood features examined included density of recreational facilities, density of healthy food stores, and survey-based measures of availability of healthy foods, walking environment, and social environment. We used econometric fixed-effects models to investigate how change in a given neighborhood exposure is related to simultaneous change in subclinical atherosclerosis. RESULTS Increases in density of neighborhood healthy food stores were associated with decreases in CAC (mean changes in CAC Agatston units per 1-SD increase in neighborhood exposures, -19.99; 95% confidence interval, -35.21 to -4.78) after adjustment for time-varying demographic confounders and computed tomography scanner type. This association remained similar in magnitude after additional adjustment for time-varying behavioral risk factors and depression. The addition of time-varying biomedical factors attenuated associations with CAC slightly (mean changes in CAC per 1-SD increase in neighborhood exposures, -17.60; 95% confidence interval, -32.71 to -2.49). Changes across time in other neighborhood measures were not significantly associated with within-person change in CAC. CONCLUSIONS Results from this longitudinal study provide suggestive evidence that greater access to neighborhood healthy food resources may slow the development of coronary atherosclerosis in middle-aged and older adults.
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Affiliation(s)
- Jeffrey J Wing
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
| | - Ella August
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
| | - Sara D Adar
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
| | - Andrew L Dannenberg
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
| | - Anjum Hajat
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
| | - Brisa N Sánchez
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
| | - James H Stein
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
| | - Matthew C Tattersall
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
| | - Ana V Diez Roux
- From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.)
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Parsons TJ, Sartini C, Ellins EA, Halcox JPJ, Smith KE, Ash S, Lennon LT, Wannamethee SG, Lee IM, Whincup PH, Jefferis BJ. Objectively measured physical activity, sedentary time and subclinical vascular disease: Cross-sectional study in older British men. Prev Med 2016; 89:194-199. [PMID: 27261410 PMCID: PMC4976831 DOI: 10.1016/j.ypmed.2016.05.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/23/2016] [Accepted: 05/28/2016] [Indexed: 11/30/2022]
Abstract
Low physical activity (PA) and high levels of sedentary time (ST) are associated with higher cardiovascular disease (CVD) risk among older people. However, their independent contribution and importance of duration of PA and ST bouts remain unclear. We investigated associations between objectively measured PA, ST and non-invasive vascular measures, markers of CVD risk. Cross-sectional study of 1216 men from the British Regional Heart Study, mean age 78.5years, measured in 2010-2012. Carotid intima thickness (CIMT), distensibility coefficient (DC) and plaque presence were measured using ultrasound; pulse wave velocity (cfPWV) and augmentation index (AIx) using a Vicorder. PA and ST were measured using hip-worn ActiGraph GT3X accelerometers. After adjusting for covariates, each additional 1000 steps per day was associated with a 0.038m/s lower cfPWV (95% CI=-0.076, 0.0003), 0.095 10(-3) kPa(-1) higher DC (95% CI=0.006, 0.185), 0.26% lower AIx (95% CI=-0.40, -0.12) and a 0.005mm lower CIMT (95% CI=-0.008, -0.001). Moderate and vigorous PA (MVPA) was associated with lower AIx and CIMT, light PA (LPA) with lower cfPWV and CIMT and ST with higher cfPWV, AIx and CIMT and lower DC. LPA and ST were highly correlated (r=-0.62). The independence of MVPA and ST or MVPA and LPA was inconsistent across vascular measures. Bout lengths for both PA and ST were not associated with vascular measures. In our cross-sectional study of older men, all PA regardless of intensity or bout duration was beneficially associated with vascular measures, as was lower ST. LPA was particularly relevant for cfPWV and CIMT.
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Affiliation(s)
- Tessa J Parsons
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, University College London, London, UK.
| | - Claudio Sartini
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, University College London, London, UK
| | - Elizabeth A Ellins
- Institute of Life Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Julian P J Halcox
- Institute of Life Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Kirsten E Smith
- Institute of Life Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Sarah Ash
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - Lucy T Lennon
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Barbara J Jefferis
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, University College London, London, UK
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Wijndaele K, Westgate K, Stephens SK, Blair SN, Bull FC, Chastin SFM, Dunstan DW, Ekelund U, Esliger DW, Freedson PS, Granat MH, Matthews CE, Owen N, Rowlands AV, Sherar LB, Tremblay MS, Troiano RP, Brage S, Healy GN. Utilization and Harmonization of Adult Accelerometry Data: Review and Expert Consensus. Med Sci Sports Exerc 2016; 47:2129-39. [PMID: 25785929 PMCID: PMC4731236 DOI: 10.1249/mss.0000000000000661] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to describe the scope of accelerometry data collected internationally in adults and to obtain a consensus from measurement experts regarding the optimal strategies to harmonize international accelerometry data. METHODS In March 2014, a comprehensive review was undertaken to identify studies that collected accelerometry data in adults (sample size, n ≥ 400). In addition, 20 physical activity experts were invited to participate in a two-phase Delphi process to obtain consensus on the following: unique research opportunities available with such data, additional data required to address these opportunities, strategies for enabling comparisons between studies/countries, requirements for implementing/progressing such strategies, and value of a global repository of accelerometry data. RESULTS The review identified accelerometry data from more than 275,000 adults from 76 studies across 36 countries. Consensus was achieved after two rounds of the Delphi process; 18 experts participated in one or both rounds. The key opportunities highlighted were the ability for cross-country/cross-population comparisons and the analytic options available with the larger heterogeneity and greater statistical power. Basic sociodemographic and anthropometric data were considered a prerequisite for this. Disclosure of monitor specifications and protocols for data collection and processing were deemed essential to enable comparison and data harmonization. There was strong consensus that standardization of data collection, processing, and analytical procedures was needed. To implement these strategies, communication and consensus among researchers, development of an online infrastructure, and methodological comparison work were required. There was consensus that a global accelerometry data repository would be beneficial and worthwhile. CONCLUSIONS This foundational resource can lead to implementation of key priority areas and identification of future directions in physical activity epidemiology, population monitoring, and burden of disease estimates.
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Affiliation(s)
- Katrien Wijndaele
- 1MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM; 2School of Public Health, University of Queensland, Queensland, AUSTRALIA; 3Department of Exercise Science, University of South Carolina, Columbia, SC; 4Schools of Earth and Environment and Sports Science Exercise and Health, University of Western Australia, Western Australia, AUSTRALIA; 5School of Health and Life Science, Glasgow Caledonian University, Scotland, UNITED KINGDOM; 6Baker IDI Heart and Diabetes Institute, Melbourne, AUSTRALIA; 7Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY; 8National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UNITED KINGDOM; 9School of Health Sciences, University of South Australia, South Australia, AUSTRALIA; 10Department of Kinesiology, University of Massachusetts, Amherst, MA; 11School of Health Sciences, University of Salford, Manchester, UNITED KINGDOM; 12Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; 13The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicestershire, UNITED KINGDOM; 14Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics, University of Ottawa, Ottawa, CANADA; and 15Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
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25
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Fonseca HAR, Bittencourt CR, Fonseca FA, Monteiro AM, Santos PR, Camargo L, Costa LAR, Murad A, Gidlund M, Figueiredo-Neto AM, Izar MCO. Non-linear Optical Responses of Low-Density Lipoprotein are Associated with Intima-Media Thickness of Carotid Artery in Athletes. Cell Biochem Biophys 2016; 74:253-62. [PMID: 27126056 DOI: 10.1007/s12013-016-0720-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 01/18/2016] [Indexed: 12/20/2022]
Abstract
We investigated the association between the degree of oxidative modification of LDL particles by non-linear optical response of LDL (Z-scan technique) and the presence of subclinical atherosclerosis in different segments of the carotid artery. We recruited high-intensity athlete runners (n = 44) and controls (n = 51) to participate in the study. The carotid intima-media thickness (cIMT), interleukin 10 (IL-10), TNF-alpha, and the non-linear optical responses of LDL particle (Z-scan) were assessed. In athletes, the mean cIMT differed between genders, with higher values observed in female athletes compared to male athletes (P < 0.05). Higher mean values for cIMT were seen in the right carotid arteries of female athletes as compared to female controls (P < 0.05). Higher levels of TNF-alpha and IL-10 were found in athletes (P < 0.05). Yet, ΔΓpv (transmittance curve) of Z-scan in athletes was higher than in the non-athletes, indicating less oxidation in LDL particles of athletes (P < 0.05). There was an inverse association between the ΔΓpv and cIMT in the right internal carotid segments (β = -0.163, P < 0.05) in all subjects, and between the VO2max and the mean cIMT (β = -0.003, P < 0.05) in male subjects. The present study shows that the Z-scan technique enabled to detect less oxidative modifications in LDL particles from athletes. This effect was associated with cIMT in a gender-dependent mode.
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Affiliation(s)
- Henrique Andrade R Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | - Célia R Bittencourt
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | - Francisco A Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | - Andrea M Monteiro
- Institute of Physics, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Priscila R Santos
- Institute of Physics, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Luciano Camargo
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | | | | | - Magnus Gidlund
- Department of Immunology, Institute of Biomedical Science IV, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - Maria Cristina O Izar
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil.
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26
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Physical activity and cardiorespiratory fitness, but not sedentary behavior, are associated with carotid intima-media thickness in obese adolescents. Eur J Pediatr 2016; 175:391-8. [PMID: 26490566 DOI: 10.1007/s00431-015-2654-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 07/15/2015] [Accepted: 10/07/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED This study aimed to analyze the associations between sedentary behavior, physical activity (PA), and cardiorespiratory fitness (CRF), with carotid intima-media thickness (cIMT), a marker of atherosclerosis already present at an early stage among obese adolescents. The associations between anthropometric measures, sedentary time, PA, CRF, and cIMT of 54 Caucasian obese adolescents were analyzed using partial correlations (controlling for age and sex) and multiple linear regressions. Differences between participants with and without a healthy CRF were also analyzed using independent sample t test. Sedentary time did not correlate with any of the variables. Light physical activity correlated positively with mean cIMT (r(38) = 0.36, p = 0.024). Moderate physical activity (MPA) correlated positively with both mean (r(38) = 0.37, p = 0.018) and maximum (r(38) = 0.33, p = 0.039) cIMT. CRF was inversely associated with mean cIMT (r(40) = -0.36, p = 0.019), even when controlling for sedentary time (r(37) = -0.35, p = 0.030). The best predictors of cIMT were MPA and weight. No significant differences in cIMT were found between participants with healthy and unhealthy CRF. CONCLUSION Although we need to be cautious due to the limitations of the study, the results suggest that despite the importance of decreasing sedentary time, increasing PA intensity may be more effective in improving endothelial structural health among obese adolescents.
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Bakrania K, Edwardson CL, Bodicoat DH, Esliger DW, Gill JMR, Kazi A, Velayudhan L, Sinclair AJ, Sattar N, Biddle SJH, Khunti K, Davies M, Yates T. Associations of mutually exclusive categories of physical activity and sedentary time with markers of cardiometabolic health in English adults: a cross-sectional analysis of the Health Survey for England. BMC Public Health 2016; 16:25. [PMID: 26753523 PMCID: PMC4709945 DOI: 10.1186/s12889-016-2694-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/06/2016] [Indexed: 02/06/2023] Open
Abstract
Background Both physical activity and sedentary behaviour have been individually associated with health, however, the extent to which the combination of these behaviours influence health is less well-known. The aim of this study was to examine the associations of four mutually exclusive categories of objectively measured physical activity and sedentary time on markers of cardiometabolic health in a nationally representative sample of English adults. Methods Using the 2008 Health Survey for England dataset, 2131 participants aged ≥18 years, who provided valid accelerometry data, were included for analysis and grouped into one of four behavioural categories: (1) ‘Busy Bees’: physically active & low sedentary, (2) ‘Sedentary Exercisers’: physically active & high sedentary, (3) ‘Light Movers’: physically inactive & low sedentary, and (4) ‘Couch Potatoes’: physically inactive & high sedentary. ‘Physically active’ was defined as accumulating at least 150 min of moderate-to-vigorous physical activity (MVPA) per week. ‘Low sedentary’ was defined as residing in the lowest quartile of the ratio between the average sedentary time and the average light-intensity physical activity time. Weighted multiple linear regression models, adjusting for measured confounders, investigated the differences in markers of health across the derived behavioural categories. The associations between continuous measures of physical activity and sedentary levels with markers of health were also explored, as well as a number of sensitivity analyses. Results In comparison to ‘Couch Potatoes’, ‘Busy Bees’ [body mass index: −1.67 kg/m2 (p < 0.001); waist circumference: −1.17 cm (p = 0.007); glycated haemoglobin: −0.12 % (p = 0.003); HDL-cholesterol: 0.09 mmol/L (p = 0.001)], ‘Sedentary Exercisers’ [body mass index: −1.64 kg/m2 (p < 0.001); glycated haemoglobin: −0.11 % (p = 0.009); HDL-cholesterol: 0.07 mmol/L (p < 0.001)] and ‘Light Movers’ [HDL-cholesterol: 0.11 mmol/L (p = 0.004)] had more favourable health markers. The continuous analyses showed consistency with the categorical analyses and the sensitivity analyses indicated robustness and stability. Conclusions In this national sample of English adults, being physically active was associated with a better health profile, even in those with concomitant high sedentary time. Low sedentary time independent of physical activity had a positive association with HDL-cholesterol. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2694-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kishan Bakrania
- Department of Health Sciences, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, United Kingdom. .,Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Danielle H Bodicoat
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Dale W Esliger
- National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC), Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
| | - Aadil Kazi
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Latha Velayudhan
- Psychiatry for the Elderly, Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.
| | - Alan J Sinclair
- Diabetes Frail Ltd, University of Aston, Birmingham, B4 7ET, UK.
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC), Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
| | - Stuart J H Biddle
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia.
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care - East Midlands (CLAHRC - EM) Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Melanie Davies
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. .,National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
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Eijsvogels TMH, Fernandez AB, Thompson PD. Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise? Physiol Rev 2016; 96:99-125. [PMID: 26607287 PMCID: PMC4698394 DOI: 10.1152/physrev.00029.2014] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Multiple epidemiological studies document that habitual physical activity reduces the risk of atherosclerotic cardiovascular disease (ASCVD), and most demonstrate progressively lower rates of ASCVD with progressively more physical activity. Few studies have included individuals performing high-intensity, lifelong endurance exercise, however, and recent reports suggest that prodigious amounts of exercise may increase markers for, and even the incidence of, cardiovascular disease. This review examines the evidence that extremes of endurance exercise may increase cardiovascular disease risk by reviewing the causes and incidence of exercise-related cardiac events, and the acute effects of exercise on cardiovascular function, the effect of exercise on cardiac biomarkers, including "myocardial" creatine kinase, cardiac troponins, and cardiac natriuretic peptides. This review also examines the effect of exercise on coronary atherosclerosis and calcification, the frequency of atrial fibrillation in aging athletes, and the possibility that exercise may be deleterious in individuals genetically predisposed to such cardiac abnormalities as long QT syndrome, right ventricular cardiomyopathy, and hypertrophic cardiomyopathy. This review is to our knowledge unique because it addresses all known potentially adverse cardiovascular effects of endurance exercise. The best evidence remains that physical activity and exercise training benefit the population, but it is possible that prolonged exercise and exercise training can adversely affect cardiac function in some individuals. This hypothesis warrants further examination.
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Affiliation(s)
- Thijs M H Eijsvogels
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antonio B Fernandez
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul D Thompson
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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Sung J, Cho SJ, Choe YH, Yoo S, Woo KG, Choi YH, Hong KP. Relationship between aerobic fitness and progression of coronary atherosclerosis. Heart Vessels 2015; 31:1418-23. [PMID: 26400860 DOI: 10.1007/s00380-015-0745-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 09/09/2015] [Indexed: 11/29/2022]
Abstract
Cross-sectional data suggest that the degree of coronary atherosclerosis is associated with aerobic fitness. However, there are limited longitudinal data addressing whether aerobic fitness is a predictor of coronary atherosclerosis progression. This study investigated whether peak oxygen consumption is related to a longitudinal increase in coronary calcium scores. Study subjects were voluntary participants in a health screening program who underwent a cardiopulmonary function test and repeated coronary calcium scoring. Individuals with clinical cardiovascular disease were excluded. The final sample included 4843 subjects with 14,856 records. The treadmill exercise test was performed using a modified Bruce protocol and Agatston coronary artery calcium (CAC) scores were measured using multi-detector CT. The mean age of the participants was 52 ± 6 years and 4.7 % were female. In a multi-level mixed effect regression model, increased CAC scores over time were significantly less likely in individuals with a higher VO2peak after adjusting for age, gender, hypertension, HbA1c, smoking status and LDL cholesterol levels (p < 0.001). Aerobic fitness has a protective effect on the progression of coronary atherosclerosis in an asymptomatic middle-aged population.
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Affiliation(s)
- Jidong Sung
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 135-710, South Korea. .,Department of Medicine, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 135-710, South Korea.
| | - Soo Jin Cho
- Department of Medicine, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 135-710, South Korea
| | - Yeon Hyeon Choe
- Department of Radiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sanghyun Yoo
- Samsung Advanced Institute of Technology, Seoul, Korea
| | - Kyoung-Gu Woo
- Samsung Advanced Institute of Technology, Seoul, Korea
| | - Yoon-Ho Choi
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 135-710, South Korea.,Department of Medicine, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 135-710, South Korea
| | - Kyung Pyo Hong
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 135-710, South Korea
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Nang EEK, van Dam RM, Tan CS, Mueller-Riemenschneider F, Lim YT, Ong KZ, Ee S, Lee J, Tai ES. Association of Television Viewing Time with Body Composition and Calcified Subclinical Atherosclerosis in Singapore Chinese. PLoS One 2015; 10:e0132161. [PMID: 26132754 PMCID: PMC4488493 DOI: 10.1371/journal.pone.0132161] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/10/2015] [Indexed: 01/17/2023] Open
Abstract
Objective Sedentary behavior such as television viewing may be an independent risk factor for coronary heart disease. However, few studies have assessed the impact of television viewing time on coronary artery calcification and it remains unclear how body fat contributes to this relationship. The aim of this study is to evaluate the association between television viewing time and subclinical atherosclerosis and whether effects on visceral or subcutaneous fat may mediate any associations observed. Methods This was a cross-sectional study of 398 Chinese participants (192 men and 206 women) from Singapore prospective study. Participants were free from known cardiovascular diseases and underwent interview, health screening, computed tomography scans of coronary arteries and abdomen. Spearman’s correlation was used to test the correlation between television viewing time, physical activity, body composition and abdominal fat distribution. The association between television viewing time and subclinical atherosclerosis was assessed by multiple logistic regression analysis. Results In men, television viewing time was significantly correlated with higher body fat mass index, percent body fat, subcutaneous and visceral fat. These associations were in the same direction, but weaker and not statistically significant in women. Television viewing time (hours/day) was associated with subclinical atherosclerosis in men (odds ratio: 1.41, 95% CI: 1.03-1.93) but no significant association was observed in women (odds ratio: 0.88, 95% CI: 0.59-1.31) after adjusting for potential socio-demographic and lifestyle confounders. Further adjustments for biological factors did not affect these associations. Conclusions Television viewing time was associated with greater adiposity and higher subcutaneous and visceral fat in men. TV viewing time was also associated with subclinical atherosclerosis in men and the potential mechanisms underlying this association require further investigation.
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Affiliation(s)
- Ei Ei Khaing Nang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- * E-mail:
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Falk Mueller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Institute for Social Medicine, Epidemiology and Health Economics, Charite Univeristy Medical Centre, Berlin, Germany
| | - Yi Ting Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Kai Zhi Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Siqing Ee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Jeannette Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - E. Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
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Gómez-Sánchez L, García-Ortiz L, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Gómez-Marcos MA. [Relationship between physical activity and hemodynamic parameters in adults]. HIPERTENSION Y RIESGO VASCULAR 2015; 32:113-8. [PMID: 26180035 DOI: 10.1016/j.hipert.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 03/06/2015] [Accepted: 03/10/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To analyze the relationship between physical activity, as assessed by accelerometer, with central and peripheral augmentation index and carotid intima media thickness (IMT) in adults. METHODS This study analyzed 263 subjects who were included in the EVIDENT study. Physical activity was assessed during 7 days using the ActigraphGT3X accelerometer (counts/min). Carotid ultrasound was used to measure carotid IMT. The Sphygmo Cor System was used to measure central and peripheral augmentation index (CAIx and PAIx). RESULTS Mean age 55.85±12 years; 59.30% female; 26.7 body mass index and blood pressure 120/77mmHg. Mean physician activity counts/min was 244.37 and 2.63±10.26min/day of vigorous or very vigorous activity. Physical activity showed an inverse correlation with PAIx (r=-0.179; P<.01) and vigorous activity day time with IMT(r=-0.174; P<.01), CAIx (r=-0.217; P<.01) and PAIx (r=-0.324; P<.01). After adjusting for confounding factors in the multiple regression analysis, the inverse association of CAIx with counts/min and the time spent in vigorous/very vigorous activity was maintained. CONCLUSION The results suggest that both physical activity and time spent in vigorous or vigorous activity are associated with the central augmentation index in adults.
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Affiliation(s)
- L Gómez-Sánchez
- Unidad de Investigación de la Alamedilla, Medicina de Familia, Centro de Salud Monovar, Atención Primaria, Servicio Madrileño de Salud, Madrid, España
| | - L García-Ortiz
- Unidad de Investigación de la Alamedilla, Medicina de Familia, Centro de Salud de la Alamedilla, Servicio de Salud de Castilla y León, Salamanca, España; Departamento de Medicina de la Universidad de Salamanca, IBSAL, Salamanca, España
| | | | - M C Patino-Alonso
- Departamento de Estadística, Universidad de Salamanca, IBSAL, Salamanca, España
| | - C Agudo-Conde
- Departamento de Estadística, Universidad de Salamanca, IBSAL, Salamanca, España
| | - M A Gómez-Marcos
- Unidad de Investigación de la Alamedilla, Medicina de Familia, Centro de Salud de la Alamedilla, Servicio de Salud de Castilla y León, Salamanca, España.
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Huang C, Wang J, Deng S, She Q, Wu L. The effects of aerobic endurance exercise on pulse wave velocity and intima media thickness in adults: A systematic review and meta-analysis. Scand J Med Sci Sports 2015; 26:478-87. [PMID: 26059748 DOI: 10.1111/sms.12495] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- C. Huang
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
| | - J. Wang
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
- Department of Cardiology; The Medical Emergency Center of Chongqing; Chongqing China
| | - S. Deng
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
| | - Q. She
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
| | - L. Wu
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
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García-Hermoso A, Martínez-Vizcaíno V, Recio-Rodríguez JI, Sánchez-López M, Gómez-Marcos MÁ, García-Ortiz L. Sedentary behaviour patterns and carotid intima-media thickness in Spanish healthy adult population. Atherosclerosis 2015; 239:571-6. [PMID: 25733329 DOI: 10.1016/j.atherosclerosis.2015.02.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/26/2014] [Accepted: 02/16/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the association between sedentary behaviour, as assessed by an accelerometer, and mean carotid intima-media thickness (IMT). METHODS The study included 263 healthy subjects belonging to the EVIDENT study (59.3% women). Carotid IMT was measured by carotid ultrasonography. Sedentary behaviour was measured objectively over 7 days using ActiGraph accelerometers. Thresholds of 10 consecutive minutes were used to establish sedentary bouts, and assess the number (n/day), and length ≥10 min (min/day). RESULTS Total sedentary time and sedentary time in bouts ≥10 min was higher in participants with a larger mean carotid IMT (>P75). Otherwise, this sedentary time in bouts ≥10 min parameter was weakly associated with augmented carotid IMT injury in the logistic regression model. CONCLUSION Total sedentary time and sedentary time in bouts ≥10 min, as assessed by accelerometer, was positively but weakly associated with carotid IMT. Equally, this sedentary time in bouts ≥10 min was associated with carotid injury, but disappears after adjusting for potential confounders. These findings support that reducing sedentary time and increasing breaks in bouts of sedentary time might represent a useful additional strategy in the cardiovascular disease prevention. TRIAL REGISTRATION Clinical Trials.gov Identifier: NCT01083082.
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Affiliation(s)
- Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Chile
| | | | | | - Mairena Sánchez-López
- Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain
| | | | - Luis García-Ortiz
- The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain
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Schwerdtfeger AR, Scharnagl H, Stojakovic T, Rathner EM. Cognitive Avoidant Coping Is Associated with Higher Carotid Intima Media Thickness Among Middle-Aged Adults. Int J Behav Med 2014; 22:597-604. [PMID: 25471467 DOI: 10.1007/s12529-014-9457-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cognitive avoidant coping (CAV) has been associated with elevated autonomic stress reactivity, thus presumably elevating risk for cardiovascular diseases. However, more direct evidence for this hypothesis is lacking. PURPOSE The purpose of this study was to relate carotid intima media thickness (IMT) to CAV in nonclinical participants. METHODS A total of 124 participants (61 women) with a mean age of 37.52 years (SD = 7.93, MIN = 30, MAX = 60) participated in the study. IMT was assessed by ultrasonic imaging and CAV via questionnaire (Mainz Coping Inventory; MCI). RESULTS Regression analysis revealed that although CAV was not significantly associated with IMT, there was a significant interaction of CAV and age. Whereas for younger adults, there was no significant relation for older individuals, CAV and IMT were significantly positively associated. CONCLUSIONS Findings suggest that CAV could constitute a risk factor for cardiovascular diseases with increasing age.
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Affiliation(s)
- Andreas R Schwerdtfeger
- Department of Psychology, Health Psychology Unit, University of Graz, Graz, Austria.
- Department of Psychology, Karl-Franzens-University Graz, 8010, Graz, Austria.
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Eva-Maria Rathner
- Department of Psychology, Health Psychology Unit, University of Graz, Graz, Austria
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Penha RCO, Yamamoto DS, Walsh IAPD, Ruas G, Accioly MF. Analysis of cardiovascular risks in practitioners of unsupervised exercises. FISIOTERAPIA EM MOVIMENTO 2014. [DOI: 10.1590/0103-5150.027.004.ao04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Physical exercise is recommended by health professionals for the prevention of cardiovascular events; for it is important that practitioners follow recommendations of qualified professionals. Objectives To analyze the cardiovascular risks and the physical exercise of regulars of a municipal public park. Materials and methods 110 regulars of a municipal public park were evaluated by questionnaire and physical examination, 60 men and 50 women with a mean age of 48.8 ± 11.76 years. Cardiovascular risk was classified according to the American Table and physical activity following the recommendations of the American College of Sports Medicine and the American Heart Association. Results Regarding the classification of cardiovascular risk, 54% of the studied population presented potential risk and 31% moderate. As for physical exercise, 58% were considered inactive, 14% active and 28% were very active. 90% received no professional guidelines. Conclusion The public park goers have cardiovascular risk and do exercise without individualized guidance.
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Non-consent to a wrist-worn accelerometer in older adults: the role of socio-demographic, behavioural and health factors. PLoS One 2014; 9:e110816. [PMID: 25343453 PMCID: PMC4208789 DOI: 10.1371/journal.pone.0110816] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 09/20/2014] [Indexed: 11/19/2022] Open
Abstract
Background Accelerometers, initially waist-worn but increasingly wrist-worn, are used to assess physical activity free from reporting-bias. However, its acceptability by study participants is unclear. Our objective is to assess factors associated with non-consent to a wrist-mounted accelerometer in older adults. Methods Data are from 4880 Whitehall II study participants (1328 women, age range = 60–83), requested to wear a wrist-worn accelerometer 24 h every day for 9 days in 2012/13. Sociodemographic, behavioral, and health-related factors were assessed by questionnaire and weight, height, blood pressure, cognitive and motor function were measured during a clinical examination. Results 210 participants had contraindications and 388 (8.3%) of the remaining 4670 participants did not consent. Women, participants reporting less physical activity and less favorable general health were more likely not to consent. Among the clinical measures, cognitive impairment (Odds Ratio = 2.21, 95% confidence interval: 1.22–4.00) and slow walking speed (Odds Ratio = 1.38, 95% confidence interval: 1.02–1.86) were associated with higher odds of non-consent. Conclusions The rate of non-consent in our study of older adults was low. However, key markers of poor health at older ages were associated with non-consent, suggesting some selection bias in the accelerometer data.
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Gomez-Marcos MA, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Lasaosa-Medina L, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, García-Ortiz L. Relationship between objectively measured physical activity and vascular structure and function in adults. Atherosclerosis 2014; 234:366-72. [DOI: 10.1016/j.atherosclerosis.2014.02.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/27/2014] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
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Sabia S, van Hees VT, Shipley MJ, Trenell MI, Hagger-Johnson G, Elbaz A, Kivimaki M, Singh-Manoux A. Association between questionnaire- and accelerometer-assessed physical activity: the role of sociodemographic factors. Am J Epidemiol 2014; 179:781-90. [PMID: 24500862 PMCID: PMC3939851 DOI: 10.1093/aje/kwt330] [Citation(s) in RCA: 190] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The correlation between objective and self-reported measures of physical activity varies between studies. We examined this association and whether it differed by demographic factors or socioeconomic status (SES). Data were from 3,975 Whitehall II (United Kingdom, 2012–2013) participants aged 60–83 years, who completed a physical activity questionnaire and wore an accelerometer on their wrist for 9 days. There was a moderate correlation between questionnaire- and accelerometer-assessed physical activity (Spearman's r = 0.33, 95% confidence interval: 0.30, 0.36). The correlations were higher in high-SES groups than in low-SES groups (P 's = 0.02), as defined by education (r = 0.38 vs. r = 0.30) or occupational position (r = 0.37 vs. r = 0.29), but did not differ by age, sex, or marital status. Of the self-reported physical activity, 68.3% came from mild activities, 25% from moderate activities, and only 6.7% from vigorous activities, but their correlations with accelerometer-assessed total physical activity were comparable (range of r 's, 0.21–0.25). Self-reported physical activity from more energetic activities was more strongly associated with accelerometer data (for sports, r = 0.22; for gardening, r = 0.16; for housework, r = 0.09). High-SES persons reported more energetic activities, producing stronger accelerometer associations in these groups. Future studies should identify the aspects of physical activity that are most critical for health; this involves better understanding of the instruments being used.
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Affiliation(s)
- Séverine Sabia
- Correspondence to Dr. Séverine Sabia, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom (e-mail: ); or Dr. Vincent T. van Hees, MoveLab—Physical Activity and Exercise Research, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom (e-mail: )
| | - Vincent T. van Hees
- Correspondence to Dr. Séverine Sabia, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom (e-mail: ); or Dr. Vincent T. van Hees, MoveLab—Physical Activity and Exercise Research, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom (e-mail: )
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Taylor BA, Zaleski AL, Capizzi JA, Ballard KD, Troyanos C, Baggish AL, D'Hemecourt PA, Dada MR, Thompson PD. Influence of chronic exercise on carotid atherosclerosis in marathon runners. BMJ Open 2014; 4:e004498. [PMID: 24531453 PMCID: PMC3927935 DOI: 10.1136/bmjopen-2013-004498] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The effect of habitual, high-intensity exercise training on the progression of atherosclerosis is unclear. We assessed indices of vascular health (central systolic blood pressure (SBP) and arterial stiffness as well as carotid intima-medial thickness (cIMT)) in addition to cardiovascular risk factors of trained runners versus their untrained spouses or partners to evaluate the impact of exercise on the development of carotid atherosclerosis. SETTING field study at Boston Marathon. PARTICIPANTS 42 qualifiers (mean age±SD: 46±13 years, 21 women) for the 2012 Boston Marathon and their sedentary domestic controls (46±12 years, n=21 women). OUTCOMES We measured medical and running history, vital signs, anthropometrics, blood lipids, C reactive protein (CRP), 10 years Framingham risk, central arterial stiffness and SBP and cIMT. RESULTS Multiple cardiovascular risk factors, including CRP, non-high-density lipoprotein cholesterol, triglycerides, heart rate, body weight and body mass index (all p<0.05), were reduced in the runners. The left and right cIMT, as well as central SBP, were not different between the two groups (all p>0.31) and were associated with age (all r≥0.41; p<0.01) and Framingham risk score (all r≥0.44; p<0.01) independent of exercise group (all p>0.08 for interactions). The amplification of the central pressure waveform (augmentation pressure at heart rate 75 bpm) was also not different between the two groups (p=0.07) but was related to age (p<0.01) and group (p=0.02) in a multiple linear regression model. CONCLUSIONS Habitual endurance exercise improves the cardiovascular risk profile, but does not reduce the magnitude of carotid atherosclerosis associated with age and cardiovascular risk factors.
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Affiliation(s)
- Beth A Taylor
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
- Department of Health Sciences, University of Hartford, Bloomfield, Connecticut, USA
| | - Amanda L Zaleski
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Jeffrey A Capizzi
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Kevin D Ballard
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | | | - Aaron L Baggish
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Marcin R Dada
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Paul D Thompson
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
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García-Ortiz L, Recio-Rodríguez JI, Schmidt-Trucksäss A, Puigdomenech-Puig E, Martínez-Vizcaíno V, Fernández-Alonso C, Rubio-Galan J, Agudo-Conde C, Patino-Alonso MC, Rodríguez-Sánchez E, Gómez-Marcos MA. Relationship between objectively measured physical activity and cardiovascular aging in the general population--the EVIDENT trial. Atherosclerosis 2014; 233:434-440. [PMID: 24530775 DOI: 10.1016/j.atherosclerosis.2014.01.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 01/08/2014] [Accepted: 01/11/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND Aging has been associated with an increase in arterial stiffness. We analyzed the relationship between regular physical activity and cardiovascular aging evaluated by the radial augmentation index (rAIx), ambulatory arterial stiffness index (AASI), pulse pressure (PP) and heart age in subjects without atherosclerotic disease. METHODS A cross-sectional study was performed including 1365 subjects from the EVIDENT trial (mean age 54.9±13.7 years; 60.3% women). As a measure of total volume of physical activity we used counts/minute recorded in an accelerometer (Actigraph GT3X) that participants wore for seven days, collecting data in 60-sec epochs, and respondents with ≥4 valid days were retained for the analysis. Arterial stiffness was evaluated using measures of rAIx, AASI, and central and peripheral PP on the B-pro device. rAIx was adjusted to 75 heart rate(rAIx75). Cardiovascular risk and heart age was estimated by the Framingham Risk Score. RESULTS The median (IQR) of counts/min was 236.9 (176.3-307.8), rAIx75 90 (77-100), sleep PP 40 mmHg (33-47), central PP 39 mmHg (32-47) and heart age 57 years (45-73) and the mean±SD of the ASSI was 0.44±0.07. We found an inverse correlation between counts/minute and rAIx75 (r=-0.086; p<0.01), AASI (r=-0.146; p<0.001), heart age (r=-0.163; p<0.001) and peripherals PP. These associations were remained after controlling for potential confounders, except for rAIx75. In the multiple regression analysis, after adjustment, an inverse association persisted between counts/minute and AASI, sleep PP and heart age, but not with rAIx75. Accordingly, for every 100 higher counts/minute of accelerometer measures, both AASI and sleep PP would be lower by one measurement unit (beta=-0.979 and -1.031 respectively, p<0.001) and the estimated heart age by half year (beta=-0.525, p=0.023). CONCLUSIONS Regular physical activity was inversely associated with parameters related to advanced cardiovascular aging after adjustment for potentially influencing variables. TRIAL REGISTRATION Clinical Trials.gov Identifier: NCT01083082.
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Affiliation(s)
- Luis García-Ortiz
- The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain.
| | - José I Recio-Rodríguez
- The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain.
| | - Arno Schmidt-Trucksäss
- Division Sports and Exercise Medicine, Institute of Exercise and Health Sciences, University of Basel, Switzerland.
| | - Elisa Puigdomenech-Puig
- Primary Health care Research Unit of Barcelona, Primary Healthcare University Research Institute IDIAP-Jordi Gol, Barcelona, Spain.
| | | | | | | | - Cristina Agudo-Conde
- The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain.
| | - Maria C Patino-Alonso
- The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain.
| | | | - Manuel A Gómez-Marcos
- The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain.
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Järvelä LS, Niinikoski H, Heinonen OJ, Lähteenmäki PM, Arola M, Kemppainen J. Endothelial function in long-term survivors of childhood acute lymphoblastic leukemia: effects of a home-based exercise program. Pediatr Blood Cancer 2013; 60:1546-51. [PMID: 23606359 DOI: 10.1002/pbc.24565] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 03/20/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND The risk for cardiovascular disease (CVD) is increased in long-term survivors of childhood acute lymphoblastic leukemia (ALL). Chemotherapy may have direct toxic effects on vascular endothelium, potentially increasing the significance of endothelial dysfunction in the development of CVD in ALL survivors. Endothelial structure and function can be measured with carotid intima media thickness (IMT) and brachial flow mediated dilation (FMD). IMT and FMD are intermediate markers of CVD. We studied endothelial function and the effects of an exercise program on vascular endothelium in long-term survivors of childhood ALL. PROCEDURE Twenty-one 16-30 year old long-term survivors of ALL (age at diagnosis ≤16 years) and 21 healthy controls were studied at baseline, and 17 of the ALL survivors participated in a 16 week home-based exercise program. IMT and FMD were studied before and after the exercise program. RESULTS At baseline, the ALL survivors had impaired overall FMD response (FMDauc, P = 0.02). FMDmax(%) was 22% lower (P = 0.06) and FMD at 40 seconds 44% lower (P = 0.01) compared to healthy controls. After the exercise program, FMD at 40 seconds (P < 0.01) and IMT (P = 0.02) improved. The mean overall FMD response increased by 25% after the exercise program, but this change was not statistically significant (P = 0.27). CONCLUSIONS Our results show that the excess burden of CVD morbidity in this population may possibly be alleviated by simple means. The importance of physical activity on the health of childhood ALL survivors should be emphasized. Longer, controlled studies are needed to confirm our findings.
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Affiliation(s)
- Liisa S Järvelä
- Department of Pediatrics, Turku University Hospital, Turku, Finland.
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Golay A, Brock E, Gabriel R, Konrad T, Lalic N, Laville M, Mingrone G, Petrie J, Phan TM, Pietiläinen KH, Anderwald CH. Taking small steps towards targets - perspectives for clinical practice in diabetes, cardiometabolic disorders and beyond. Int J Clin Pract 2013; 67:322-32. [PMID: 23521324 DOI: 10.1111/ijcp.12114] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 12/18/2012] [Indexed: 01/26/2023] Open
Abstract
Big changes are hard. When trying to achieve guideline targets in diabetes and cardiometabolic disorders, patients can lack commitment or suffer despondency. It is much easier to make small changes in lifestyle or treatment, which are less noticeable and easier to manage long-term. Obesity is central to the cardiometabolic disorders, and even small weight losses of 2-5% can improve the cardiometabolic risk profile and substantially reduce the risk of developing type 2 diabetes. Likewise, small increases in physical activity, such as 15-30 min of brisk walking per day, can cut the risk of heart disease by 10%. Lifestyle or treatment changes that lead to small improvements in metabolic parameters also impact patient outcome - for example, a 5 mmHg decrease in blood pressure can translate into significant reductions in the rates of myocardial infarction and cardiovascular mortality. Benefits of small changes can also be seen in health economic outcome models. Implementing change at an individual versus a population level has different implications for overall benefit and patient motivation. Even very small steps taken in trying to reach guideline targets should represent a positive achievement for patients. Patient engagement is essential - only when patients commit themselves to change can benefits be maintained, and physicians should recognise their influence. Small changes in individual parameters can result in significant beneficial effects; however, a major impact can occur when small changes are made together in multiple parameters. More research is required to elucidate the full impact of small changes on patient outcome.
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Affiliation(s)
- A Golay
- Division of Therapeutical Teaching for Chronic Diseases, University Hospital Geneva, Geneva, Switzerland.
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Abstract
We propose that the well-documented therapeutic actions of repeated physical activities over human lifespan are mediated by the rapidly turning over proto-oncogenic Myc (myelocytomatosis) network of transcription factors. This transcription factor network is unique in utilizing promoter and epigenomic (acetylation/deacetylation, methylation/demethylation) mechanisms for controlling genes that include those encoding intermediary metabolism (the primary source of acetyl groups), mitochondrial functions and biogenesis, and coupling their expression with regulation of cell growth and proliferation. We further propose that remote functioning of the network occurs because there are two arms of this network, which consists of driver cells (e.g., working myocytes) that metabolize carbohydrates, fats, proteins, and oxygen and produce redox-modulating metabolites such as H₂O₂, NAD⁺, and lactate. The exercise-induced products represent autocrine, paracrine, or endocrine signals for target recipient cells (e.g., aortic endothelium, hepatocytes, and pancreatic β-cells) in which the metabolic signals are coupled with genomic networks and interorgan signaling is activated. And finally, we propose that lactate, the major metabolite released from working muscles and transported into recipient cells, links the two arms of the signaling pathway. Recently discovered contributions of the Myc network in stem cell development and maintenance further suggest that regular physical activity may prevent age-related diseases such as cardiovascular pathologies, cancers, diabetes, and neurological functions through prevention of stem cell dysfunctions and depletion with aging. Hence, regular physical activities may attenuate the various deleterious effects of the Myc network on health, the wild side of the Myc-network, through modulating transcription of genes associated with glucose and energy metabolism and maintain a healthy human status.
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Affiliation(s)
- Kishorchandra Gohil
- Exercise Physiology Laboratory, Dept. of Integrative Biology, University of California, Berkeley, CA 94720, USA
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44
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Ranadive SM, Yan H, Weikert M, Lane AD, Linden MA, Baynard T, Motl RW, Fernhall B. Vascular dysfunction and physical activity in multiple sclerosis. Med Sci Sports Exerc 2012; 44:238-43. [PMID: 21775908 DOI: 10.1249/mss.0b013e31822d7997] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is an inflammatory disorder of the brain and spinal cord. Disability status and progression are associated with reduced physical activity (PA) and cardiovascular function. Lack of adequate PA combined with inflammation may create high susceptibility to subclinical atherosclerosis and vascular dysfunction. PURPOSE The purpose of this study was to compare subclinical atherosclerosis and arterial function between individuals with and without MS matched for age, sex, and body mass index. METHODS Thirty-three individuals diagnosed with MS and 33 controls underwent strain gauge plethysmography for resting forearm blood flow (FBF) and peak reactive hyperemia for the microvascular function. Intima-media thickness and arterial compliance (AC) were measured using carotid ultrasound for vascular function. C-reactive protein and PA (7-d accelerometer data) were also measured. RESULTS There was a significant difference (P < 0.05) in resting FBF, peak reactive hyperemia, central pulse wave velocity, and AC between the MS and control groups. PA was associated with peak FBF and central pulse wave velocity but not FBF and carotid AC. Individuals with MS exhibit reduced arterial function but similar intima-media thickness compared with controls. Persons with MS had significantly reduced PA levels compared with controls, and PA accounted for differences in arterial function between groups. CONCLUSIONS These results indicate that subclinical markers of atherosclerosis are higher in individuals with MS, suggesting a higher risk of cardiovascular disease in this population. However, the higher levels of subclinical atherosclerosis were accounted for by the low PA in persons with MS, suggesting that increasing PA may reduce the increase in cardiovascular disease risk in patients with MS.
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Affiliation(s)
- Sushant M Ranadive
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Abstract
Thickening of the carotid artery wall has been adopted as a surrogate marker of pre-clinical atherosclerosis, which is strongly related to increased cardiovascular risk. The cardioprotective effects of exercise training, including direct effects on vascular function and lumen dimension, have been consistently reported in asymptomatic subjects and those with cardiovascular risk factors and diseases. In the present review, we summarize evidence pertaining to the impact of exercise and physical activity on arterial wall remodelling of the carotid artery and peripheral arteries in the upper and lower limbs. We consider the potential role of exercise intensity, duration and modality in the context of putative mechanisms involved in wall remodelling, including haemodynamic forces. Finally, we discuss the impact of exercise training in terms of primary prevention of wall thickening in healthy subjects and remodelling of arteries in subjects with existing cardiovascular disease and risk factors.
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46
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Physical activity, adiponectin, and cardiovascular structure and function. Heart Vessels 2011; 28:91-100. [DOI: 10.1007/s00380-011-0215-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 12/02/2011] [Indexed: 02/02/2023]
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Hamer M, Venuraju SM, Lahiri A, Rossi A, Steptoe A. Objectively assessed physical activity, sedentary time, and coronary artery calcification in healthy older adults. Arterioscler Thromb Vasc Biol 2011; 32:500-5. [PMID: 22075247 DOI: 10.1161/atvbaha.111.236877] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Physical activity is related to lower risk of cardiovascular disease, but data relating to coronary lesions have been conflicting. These inconsistencies may in part be due to unreliable assessment of physical activity and limitations imposed by self-reported data. The purpose of this study was to determine the relationship between objectively measured physical activity and coronary artery calcium (CAC). METHODS AND RESULTS Participants were 443 healthy men and women (mean age=66±6 years), without history or objective signs of coronary heart disease, drawn from the Whitehall II epidemiological cohort. Physical activity was objectively measured using accelerometers worn during waking hours for 7 consecutive days (average daily wear time=889±68 minutes/day). CAC was measured in each participant using electron beam computed tomography and was quantified according to the Agatston scoring system. On average, 54.4% of the sample recorded at least 30 minutes/day of moderate to vigorous physical activity (MVPA). There was no association between MVPA and presence of detectable CAC. For the participants with detectable CAC (n=283) a weak inverse relationship between MVPA (minutes/day) and log Agatston score was observed (B=-0.008, 95% CI: -0.16 to 0.00, P=0.05), although the association was no longer present after adjustments for age, sex, and conventional risk factors. No associations were seen for light activity or sedentary time. CONCLUSIONS Our results confirm no association between objectively assessed physical activity and CAC. Because CAC measures cannot identify more vulnerable lesions, additional studies are required to examine whether physical activity can promote plaque stability.
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Affiliation(s)
- Mark Hamer
- Department of Epidemiology and Public Health, 1-19 Torrington Pl, University College London, London, WC1E 6BT, United Kingdom.
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Abstract
Background—
Impairment of vascular endothelial function and increased intima-media thickness (IMT) are important early steps in atherogenesis. Longitudinal data on the effect of physical activity on endothelial function and IMT in healthy adolescents are lacking. We investigated prospectively the association of leisure-time physical activity with endothelial function (brachial artery flow-mediated dilatation; FMD) and aortic IMT in adolescents.
Methods and Results—
FMD and IMT were measured with ultrasonography at 13 (n=553), 15 (n=531), and 17 (n=494) years of age in adolescents participating in a longitudinal atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children). Mean aortic IMT, maximum FMD, and total FMD response (area under the dilatation curve 40 to 180 seconds after hyperemia) were calculated. Leisure-time physical activity was assessed with a questionnaire, and metabolic equivalent (MET) hours per week of leisure-time physical activity were calculated by multiplying weekly mean exercise intensity, duration, and frequency. Leisure-time physical activity was directly associated with endothelial function (
P
for maximum FMD=0.0021,
P
for total FMD response=0.0036) and inversely with IMT (
P
=0.011) after adjustment for age, sex, body mass index, high-density lipoprotein/total cholesterol, systolic blood pressure, and C-reactive protein and regarding FMD brachial artery diameter. Sedentary adolescents who increased their leisure-time physical activity from <5 to >5 (IMT) or >30 (maximum FMD) MET h/wk between 13 and 17 years of age had an increased maximum FMD (
P
=0.031) and decreased progression of IMT (
P
=0.047) compared with adolescents who remained sedentary. IMT progression was attenuated in persistently active adolescents compared with those who became sedentary (
P
=0.0072).
Conclusions—
Physical activity is favorably associated with endothelial function and IMT in adolescents. Importantly, a moderate increase in physical activity is related to decreased progression of IMT. A physically active lifestyle seems to prevent the development of subclinical atherosclerotic vascular changes in healthy adolescents.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00223600 (STRIP19902010).
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Gando Y, Yamamoto K, Kawano H, Murakami H, Ohmori Y, Kawakami R, Sanada K, Higuchi M, Tabata I, Miyachi M. Attenuated Age-Related Carotid Arterial Remodeling in Adults with a High Level of Cardiorespiratory Fitness. J Atheroscler Thromb 2011; 18:248-54. [DOI: 10.5551/jat.6924] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Conventional and behavioral risk factors explain differences in sub-clinical vascular disease between black and Caucasian South Africans: the SABPA study. Atherosclerosis 2010; 215:237-42. [PMID: 21208616 DOI: 10.1016/j.atherosclerosis.2010.12.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 11/30/2010] [Accepted: 12/02/2010] [Indexed: 01/28/2023]
Abstract
OBJECTIVES There is an emerging burden of cardiovascular disease among urban black Africans in South Africa, which has been largely explained by the transition from traditional African lifestyles to more westernized behavior. We examined the role of health behaviors in explaining the excess burden of sub clinical vascular disease seen in black Africans compared to Caucasians. METHODS This was a cross-sectional study, comprising of urban African teachers (n=192 black, 206 Caucasian) working for one of the four Kenneth Kaunda Education districts in the North West Province, South Africa. Conventional cardiovascular risk factors, 24 h ambulatory blood pressure and objectively measured physical activity (Actical® accelerometers), smoking (confirmed by serum cotinine), and alcohol (serum gamma glutamyl transferase) were assessed. The main outcome was a marker of sub-clinical vascular disease, mean carotid intima media thickness (mCIMT), measured using high resolution ultrasound. RESULTS Compared with Caucasians, the black Africans demonstrated higher mCIMT (age and sex adjusted β=0.044, 95% CI, 0.024-0.064 mm). The blacks also had higher 24h systolic and diastolic blood pressure, triglycerides, adiposity, and C-reactive protein. In addition, blacks were less physically active (790.0 kcal/d vs 947.3 kcal/d, p<0.001), more likely to smoke (25% vs 16.3%, p=0.002), and demonstrated higher alcohol abuse (gamma glutamyl transferase, 66.6 μ/L vs 27.2 μ/L, p<0.001) compared with Caucasians. The difference in mCIMT between blacks and Caucasians was attenuated by 34% when conventional risk factors were added to the model and a further 18% when health behaviors were included. CONCLUSION There is an excess burden of sub clinical vascular disease seen in black Africans compared to Caucasians, which can be largely explained by health behaviors and conventional risk factors.
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