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Gaesser GA, Hall SE, Angadi SS, Poole DC, Racette SB. Increasing the health span: unique role for exercise. J Appl Physiol (1985) 2025; 138:1285-1308. [PMID: 40244910 DOI: 10.1152/japplphysiol.00049.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 02/21/2025] [Accepted: 04/02/2025] [Indexed: 04/19/2025] Open
Abstract
Health span, that period between birth and onset of major disease(s), when adequate physical and cognitive function permit those daily living activities essential to life quality, is lower in the United States than other developed countries. Physical inactivity and excessive calorie intake occupy dominant roles both in the problem, and by redressing them, in the solution. Consequently, this review focuses on evidence that appropriate exercise engagement and calorie restriction (CR) can improve physical and mental health with a view to extending the health span. Humanity, writ large, has grasped these underlying concepts for Millennia but has been largely intransigent to them. Thus, the final section proposes a novel Monty Python-esque approach that encompasses humanity's inimical sense of humor to increase physical fitness and mental health, restore energy balance, sustain better cognitive function, and extend the health span.
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Affiliation(s)
- Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, Arizona, United States
| | - Stephanie E Hall
- Colleges of Veterinary Medicine and Health and Human Sciences, Kansas State University, Manhattan, Kansas, United States
| | - Siddhartha S Angadi
- School of Health Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - David C Poole
- Colleges of Veterinary Medicine and Health and Human Sciences, Kansas State University, Manhattan, Kansas, United States
| | - Susan B Racette
- College of Health Solutions, Arizona State University, Phoenix, Arizona, United States
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Bosire M, Mitaru D, Olale J, Mbuka S, Obuya M, Ochieng R, Oyugi B, Muniu E, Mutai J, Parmar D, Kaduka L, Harding S. Physical activity levels and its associated factors among adults in Vihiga county, Kenya. PLOS GLOBAL PUBLIC HEALTH 2025; 5:e0004651. [PMID: 40435190 PMCID: PMC12118921 DOI: 10.1371/journal.pgph.0004651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Accepted: 04/29/2025] [Indexed: 06/01/2025]
Abstract
Sedentary lifestyle is a major risk factor for cardiovascular diseases (CVDs) which account for 8% of Kenya's non-communicable disease (NCD) burden. Prevalence of physical inactivity remains high globally. There is paucity of data on physical activity levels in rural Sub-Saharan Africa to inform effective interventions. This study sought to establish levels and factors associated with physical activity in a rural population in Kenya. This was a cross-sectional study in Vihiga, a predominantly rural County in Kenya. Participants were adults aged ≥18 years drawn from four community markets. Stratified sampling by ecological zones and rural/urban status was used to select the four markets and Sampling the Next Customer Exiting the Market method for the respondents. Researcher administered e-questionnaire adapted from International Physical Activity Questionnaire (IPAQ) was used to collect data. Physical activity was calculated as the sum of all Metabolic Equivalents (MET)-minutes/week. Multivariable binary logistic regression analysis was used to identify correlates of physical activity. Out of the total 375 (m: 49%; f: 51%) participants, 27% were physically inactive (m: 22%; f: 32%;) and 42% engaged in low level physical activity. Majority of the respondents (75.5%) engaged in transportation-related physical activity while 32% engaged in leisure physical activities. The odds of being physically inactive were 1.93 times higher for females, 2.62 higher for those aged ≥65 years, and 3.62 higher for those with high health literacy. 48% with high health literacy were in the early working age group (15-24 years). Majority (53%) received health information from healthcare workers, especially for the 60% physically inactive participants. This study highlights the need for targeted community interventions to address the observed physical inactivity especially among women and older adults in rural Kenya.
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Affiliation(s)
- Miriam Bosire
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Doreen Mitaru
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Joanna Olale
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Schiller Mbuka
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Melvine Obuya
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rodgers Ochieng
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Boniface Oyugi
- Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Erastus Muniu
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Joseph Mutai
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Divya Parmar
- School of Population Health Sciences and School of Life Course Sciences, King’s College London, London, United Kingdom
| | - Lydia Kaduka
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Seeromanie Harding
- School of Population Health Sciences and School of Life Course Sciences, King’s College London, London, United Kingdom
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Grimaud Q, Malloggi L, Moret L, Rowe F, Fleury-Bahi G, Tripodi D. Factors for adherence to a physical activity promotion program in the workplace: a systematic review. BMC Public Health 2025; 25:1827. [PMID: 40382548 PMCID: PMC12085059 DOI: 10.1186/s12889-025-22775-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2025] [Accepted: 04/11/2025] [Indexed: 05/20/2025] Open
Abstract
INTRODUCTION The health benefits of physical activity (PA) are now widely accepted and proven. Promoting PA in the workplace is therefore of major public health interest, but is limited by employees' adherence. METHOD A systematic review was therefore carried out to identify factors for adherence to PA promotion program in the workplace (primary outcome); health outcomes were to be regarded as secondary outcomes. Four databases, PubMed, Web of Science, Cochrane Central Register of Controlled Trials (Cochrane CRCTs) and PsycInfo were searched to find all pertinent articles published from 2000 until June 2024. Only randomized controlled trials (RCTs) and clinical trials were selected. RESULTS More than 9000 publications were analyzed and 91 were retrieved. Two main types of study were identified: 46 non-supervised PA programs (NSPAPs) supported by socio-cognitive theories, and 45 supervised (tailored) programs (SPAPs). Concerning the primary outcome, the main factors identified for adherence were the levels of baseline PA, health and motivation of the individual; intervention individualization at the interventional level; and work environment quality at the organizational level. This review highlighted significant health benefits in both types of study, with effect sizes ranging from small to large. DISCUSSION Assessing these factors for adherence emerges as an essential prerequisite before implementing a PA promotion program in the workplace. According to our results, implementing NSPAPs, supported by socio-cognitive theories, is rather complex, and such programs can be difficult to operationalize in their entirety; consequently, coach-supervised PAPs based on RCT programs tend to be more effective. CONCLUSION Our results prove the short and medium-term beneficial effect on health of PAP in the workplace based on rigorous methodology such as RCTs. Management's support through work organization and the follow-up of actions in the long term are an essential factor for adherence to these programs. Finally, we suggest what this literature review contributes for future research or entrepreneurial and/or political projects. In fine, new models of working time will have to be considered.
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Affiliation(s)
- Quentin Grimaud
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital (CHU), Nantes, France
| | - Lucie Malloggi
- INSERM UMR1246, Methods in Patients-Centered Outcomes and Health Research, SPHERE, Nantes University, Tours University, Nantes, France
- Service de Santé Publique Et Environnementale, Nantes University Hospital, Nantes, France
| | - Leila Moret
- INSERM UMR1246, Methods in Patients-Centered Outcomes and Health Research, SPHERE, Nantes University, Tours University, Nantes, France
- Service de Santé Publique Et Environnementale, Nantes University Hospital, Nantes, France
| | - Frantz Rowe
- IAE Nantes, LEMNA, Nantes Université, Institut Universitaire de France, Nantes, France
| | - Ghozlane Fleury-Bahi
- UR 4638-LPPL, Laboratoire de Psychologie Des Pays de Loire. Nantes Université, Université d'Angers, Nantes, France
| | - Dominique Tripodi
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital (CHU), Nantes, France.
- UR 4638-LPPL, Laboratoire de Psychologie Des Pays de Loire. Nantes Université, Université d'Angers, Nantes, France.
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Sun Y, Liu Y. Circulating Cytokines Mediate the Protective Effect of Physical Activity on Cardiovascular Diseases: A Mendelian Randomization Mediation Analysis. Int J Mol Sci 2025; 26:4615. [PMID: 40429759 PMCID: PMC12111116 DOI: 10.3390/ijms26104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2025] [Revised: 05/03/2025] [Accepted: 05/10/2025] [Indexed: 05/29/2025] Open
Abstract
Cardiovascular diseases (CVDs) represent a major public health concern globally, being one of the leading causes of illness and death across populations. While physical activity is widely recognized as a protective factor against these diseases, the exact biological mechanisms that explain this relationship are still not fully understood. This study utilized a two-sample Mendelian randomization (MR) method to investigate the potential role of circulating cytokines in mediating the effects of physical activity on major CVD outcomes, including coronary artery disease (CAD), heart failure (HF), and ischemic heart disease (IHD). Our primary MR analysis revealed an inverse association between physical activity and IHD risk. Moreover, a two-step MR mediation approach identified IL10RB (Interleukin-10 receptor subunit beta) as an intermediate mediator, explaining about 6.65% of the observed contribution of physical activity to IHD. These results indicate that physical activity may mitigate CVD risk through modulation of immune pathways, particularly via IL10RB signaling. Our findings underscore the significance of cytokine networks in mediating the cardiovascular benefits of exercise and suggest potential therapeutic strategies for CVD risk reduction through immune system modulation.
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Affiliation(s)
| | - Yining Liu
- Department of Sports Science, Hanyang University ERICA, Ansan 15588, Republic of Korea;
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Berry JD, Zabad N, Kyrouac D, Leonard D, Barlow CE, Pavlovic A, Shuval K, Levine BD, DeFina LF. High-Volume Physical Activity and Clinical Coronary Artery Disease Outcomes: Findings From the Cooper Center Longitudinal Study. Circulation 2025; 151:1299-1308. [PMID: 40255152 DOI: 10.1161/circulationaha.124.070335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 02/03/2025] [Indexed: 04/22/2025]
Abstract
BACKGROUND High-volume physical activity (PA) is associated with a higher prevalence of subclinical coronary artery disease (CAD). However, the clinical significance of subclinical CAD among high-volume exercisers remains incompletely understood, and the dose-response relationship between high-volume PA and clinical CAD events remains uncertain. METHODS Individual participant data from the Cooper Center Longitudinal Study (1987-2018) were linked to Medicare claims files. PA volume was determined by self-report and categorized as <500, 500 to 1499, 1500 to 2999, and ≥3000 metabolic equivalent of task (MET)-minutes per week. Subclinical CAD (coronary artery calcium [CAC]) was measured by cardiac computed tomography. All other risk factors were measured in the standard fashion. Composite CAD events (acute myocardial infarction and revascularization) and all-cause mortality were determined from Medicare claims files. A multivariable-adjusted proportional hazards illness-death model with random shared frailty was used to estimate the association between PA volume, CAC, and both clinical CAD and death. Heterogeneity in the association between CAC and clinical CAD across levels of PA was determined with multiplicative interaction terms. RESULTS We included 26 724 participants (54 years of age; 28% women). Mean exercise volume was 1130 MET-minutes per week, with 1997 (7.5%) reporting ≥3000 MET-minutes per week. After a mean follow-up of 20.5 years, we observed 811 acute myocardial infarction events, 1636 composite CAD events, and 2857 deaths without CAD. Compared with individuals exercising <500 MET-minutes per week, the lowest risk for acute myocardial infarction occurred among individuals with intermediate PA volumes (500-1499 MET-minutes per week: hazard ratio [HR], 0.77 [95% CI, 0.65-0.91]; 1500-2499 MET-minutes per week: HR, 0.78 [95% CI, 0.63-0.95]). There was no association between high-volume PA (>3000 MET-minutes per week) and risk for acute myocardial infarction (HR, 0.95 [95% CI, 0.72-1.25]). In contrast, the lowest risk for death was observed among the high-volume PA group (HR, 0.71 [95% CI, 0.60-0.83]). CAC (on log scale) was associated with a higher risk for composite CAD across all PA categories, including among the high-volume PA subgroup (HR, 1.29 [95% CI, 1.16-1.44]; P<0.001; Pinteraction= 0.969). CONCLUSIONS Compared with low-volume PA, high-volume PA was associated with a lower risk for all-cause mortality but a similar risk for clinical CAD. CAC was associated with an increased risk for clinical CAD regardless of the volume of PA.
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Affiliation(s)
- Jarett D Berry
- Department of Internal Medicine, University of Texas at Tyler School of Medicine (J.D.B., N.Z.)
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.D.B., D.K., B.D.L.)
| | - Noor Zabad
- Department of Internal Medicine, University of Texas at Tyler School of Medicine (J.D.B., N.Z.)
| | - Douglas Kyrouac
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.D.B., D.K., B.D.L.)
| | - David Leonard
- Kenneth H. Cooper Institute, Texas Tech University Health Sciences Center, Dallas (D.L., C.E.B., A.P., K.S., L.F.D.)
| | - Carolyn E Barlow
- Kenneth H. Cooper Institute, Texas Tech University Health Sciences Center, Dallas (D.L., C.E.B., A.P., K.S., L.F.D.)
| | - Andjelka Pavlovic
- Kenneth H. Cooper Institute, Texas Tech University Health Sciences Center, Dallas (D.L., C.E.B., A.P., K.S., L.F.D.)
| | - Kerem Shuval
- Kenneth H. Cooper Institute, Texas Tech University Health Sciences Center, Dallas (D.L., C.E.B., A.P., K.S., L.F.D.)
| | - Benjamin D Levine
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (J.D.B., D.K., B.D.L.)
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.D.L.)
| | - Laura F DeFina
- Kenneth H. Cooper Institute, Texas Tech University Health Sciences Center, Dallas (D.L., C.E.B., A.P., K.S., L.F.D.)
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O'Donoghue L, Crognale D, Delahunt E, Smolenski A. Effects of exercise on cAMP-mediated platelet inhibition in young women: a pilot study. Eur J Appl Physiol 2025; 125:1283-1296. [PMID: 39636435 DOI: 10.1007/s00421-024-05673-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 11/21/2024] [Indexed: 12/07/2024]
Abstract
PURPOSE Exercise has been shown to reduce platelet reactivity and increase platelet sensitivity to prostacyclin, an endothelium-derived inhibitor of platelet activation, in middle-aged men and women. It is currently unknown if these beneficial effects can also be observed in young women and the intracellular mechanisms involved have not been identified. In this study, the feasibility of detecting changes in platelet reactivity, prostacyclin sensitivity and cAMP signalling were tested. METHODS 10 well-trained and 10 sedentary but healthy young women participated in this study. Responses of washed platelets to thrombin receptor activating peptide 6, the thromboxane A2 receptor agonist U46619, and prostaglandin E1 were measured by light transmission aggregometry. Expression levels of proteins in the cAMP pathway including phosphorylation of the vasodilator-stimulated phosphoprotein were analysed by western blotting. RESULTS There was no evidence of reduced basal reactivity in platelets from the well-trained group (V ˙ O 2 max = 51.1 ± 3.6 ml/kg/min) compared to the untrained group (V ˙ O 2 max = 31.1 ± 4.7 ml/kg/min). Platelets from the trained group showed evidence of greater sensitivity to the anti-aggregatory effects of prostaglandin E1. The slope of the aggregation curves indicated an overall faster rate of aggregation in the untrained group. Mean phosphorylation levels of vasodilator-stimulating phosphoprotein were consistently higher in the trained group, indicative of increased protein kinase A activity. CONCLUSION Platelets from young women may exhibit an exercise-induced increase in sensitivity to prostacyclin leading to stimulation of the cAMP pathway. A larger study is warranted to explore this vasoprotective effect further.
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Affiliation(s)
- Lorna O'Donoghue
- UCD School of Medicine, UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, D02 YN77, Ireland
| | - Domenico Crognale
- Institute for Sport and Health, University College Dublin, Newstead Building C Belfield, Dublin 4, Ireland
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, UCD, Health Science Centre, Belfield, Dublin 4, Ireland
| | - Albert Smolenski
- UCD School of Medicine, UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, D02 YN77, Ireland.
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Grasset L, Bis JC, Frenzel S, Kojis D, Simino J, Yaqub A, Beiser A, Berr C, Bressler J, Bülow R, DeCarli CS, Fohner AE, Harrington LB, Helmer C, Ikram MA, Lemaitre RN, Lopez OL, Longstreth WT, Neitzel J, Odden MC, Palta P, Schmidt CO, Talluri R, Vernooij MW, Völzke H, Voortman T, Whalen Q, Wittfeld K, Grabe HJ, Mosley TH, Psaty BM, Wolters FJ, Seshadri S, Dufouil C. Selected social and lifestyle correlates of brain health markers: the Cross-Cohort Collaboration Consortium. Alzheimers Dement 2025; 21:e70148. [PMID: 40207408 PMCID: PMC11982914 DOI: 10.1002/alz.70148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 01/20/2025] [Accepted: 03/06/2025] [Indexed: 04/11/2025]
Abstract
INTRODUCTION To investigate the associations of education level, marital status, and physical activity with dementia risk and brain MRI markers. METHODS Data from six community-based samples from the Cross-Cohort Collaboration Consortium were analyzed. Self-reported education level, marital status, and physical activity at age 60 to 75 years were harmonized. Subsamples of participants with brain MRI markers at time of exposure were selected. Associations with dementia risk and cross-sectional MRI markers were meta-analyzed. RESULTS Higher education level was associated with lower dementia risk (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.59; 0.72 vs low level) but not significantly with brain MRI markers. Compared with being unmarried, being married was only associated with higher total brain and hippocampal volumes. Being physically active was associated with lower dementia risk (HR = 0.73, 95% CI = 0.52; 1.04), as well as larger total brain volume and smaller white matter hyperintensity volume. DISCUSSION This study provides further evidence regarding the contribution of education level and physical activity to dementia resilience. HIGHLIGHTS Education level, marital status, and physical activity are thought to contribute to resilience against ADRD. We used random-effects meta-analysis to summarize results from six community-based samples from the CCC. In this cross-cohort meta-analysis, higher education level and being physically active were associated with lower risk of dementia. In cross-sectional analyses, being married was associated with larger TBV and HV, while being physically active was associated with larger TBV and lower WMHV.
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Hsu CW, Chang CC, Lam F, Liu MC, Yeh CC, Chen TL, Lin CS, Liao CC. Postoperative Adverse Outcomes in Patients With Frailty Undergoing Urologic Surgery Among American Patients: A Propensity-Score Matched Retrospective Cohort Study. Clin Epidemiol 2025; 17:241-250. [PMID: 40093967 PMCID: PMC11910937 DOI: 10.2147/clep.s493366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 02/21/2025] [Indexed: 03/19/2025] Open
Abstract
Objective Although the 5-item modified frailty index (mFI-5) has been found to be associated postoperative outcomes, there are limited studies examining its utility in urologic surgery. Our purpose is to evaluate the association between the mFI-5 and postoperative mortality and complications among patients undergoing urologic surgery. Methods This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database from 2015 to 2020. All adult patients who underwent urologic procedures were included. The mFI-5 includes five items: hypertension, diabetes, congestive heart failure, chronic obstructive pulmonary disease, and physical function status. Each item is assigned one point, and an mFI-5 score of 2 or greater indicates frailty. The primary outcome was postoperative mortality, while secondary outcomes were postoperative complications. Propensity score analysis was employed to control for confounders. Results After propensity score matching, each group contained 55,322 surgical patients. The patients in the frailty group were at risks of in-hospital mortality (absolute risk increase [ARI] 0.29%) and higher postoperative complications, including acute myocardial infarction (ARI 0.25%), pneumonia (ARI 0.42%), sepsis (ARI 0.41%), and septic shock (0.2%). Compared to the non-frailty group, the length of hospital stay was higher in the frailty group. Conclusion Patients with an mFI-5 score of 2 or greater were associated with an increased risk of postoperative mortality and complications, including myocardial infarction, pneumonia, sepsis, and septic shock. The mFI-5 is a simple index that quickly identifies frail patients. This allows for the implementation of prehabilitation and nutritional strategies targeted at enhancing their physiological reserve and optimizing their surgical outcomes.
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Affiliation(s)
- Cheng-Wei Hsu
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chuen-Chau Chang
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fai Lam
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ming-Che Liu
- Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan
- School of Dental Technology, College of oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chieh Yeh
- Department of Surgery, China Medical University Hospital, Tachung, Taiwan
- Department of Surgery, University of Illinois, Chicago, IL, USA
| | - Ta-Liang Chen
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chao-Shun Lin
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Chang Liao
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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Konlan KD, Afaya A, Anaman-Torgbor JA, Adedia D, Todzro-Agudze M, Biney AC, Kuug A, Mumuni H, Baiden F, HyoJung S, Kim S. Risk factors of CVDs among residents of resource-limited rural settings. Preliminary findings based on a cross-sectional study, Ghana. BMC Cardiovasc Disord 2025; 25:164. [PMID: 40055593 PMCID: PMC11889812 DOI: 10.1186/s12872-025-04594-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/19/2025] [Indexed: 05/13/2025] Open
Abstract
BACKGROUNDS Cardiovascular disease (CVD) risk factors lead to morbidity and mortality among adults globally. In Ghana, there is a lack of coordinated efforts at all levels of healthcare service to prevent risk factors of cardiovascular disease (CVD). This study assessed cardiovascular disease risk factors among residents of resource-limited rural settings. METHODS This descriptive cross-sectional design is the first phase of a two-year community-level study aimed at implementing an intervention to reduce CVD risk in a rural community in Ghana. The study population included 379 people living in the Avenui community. We conducted a nurse-led door-to-door visit, screened for CVD risk, provided health education, and collected data using an adapted questionnaire. The data were analyzed using SPSS. Categorical data were expressed as frequencies and proportions, and the Chi-Square test of associations. A multivariable logistic regression analysis with a backward elimination method was used to examine the association of the risk factors with the risk of developing CVD. RESULTS The CVD risk among participants was categorized as 'very high' (35.4%), high (55.4%), and low or moderate (9.2%). There was a positive correlation between lifestyle (r = 0.126, p-value < 0.05), stress (r = 0.114, p-value < 0.05), blood sugar level (r = 0.102, p-value < 0.05) inflammation and pain (r = 0.109, p-value < 0.05), and high blood pressure (r = 0.268, p-value < 0.01) with history of CVD. CVD high risk was significantly associated with marital status (p-value = 0.001), employment status (p-value = 0.001), perception of personal health (p-value = 0.045), lifestyle (p-value = 0.034), knowledge of peripheral arterial disease (p-value = 0.018), and knowledge on deep vein thrombosis and pulmonary embolism (p-value = 0.002). The backward multiple logistic regression model was significant (78.912, p-value < 0.001) with a non-significant Hosmer and Lemeshow Test (2.145, p-value = 0.976) and a Cox & Snell R Square and Nagelkerke R Square of 0.393 and 0.619, respectively. The significant predictors of a 'very high' CVD risk include marital status being single (p-value = 0.001), those that exercise only two (2) times a week (p-value = 0.001) employment status being part-time worker (p-value = 0.015), poor perception of overall personal health (p-value < 0.001), and those listening to the radio (p-value = 0.024). CONCLUSION The risk factors associated with CVD were identified to be multiple and interacted variable among rural community dwellers. These factors included marital status, exercise, employment, perception of health, and listening to the radio. We recommend implementing primary prevention strategies that involve adopting a comprehensive assessment and management of the risk factors of CVD in Ghana.
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Affiliation(s)
- Kennedy Diema Konlan
- Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Judith A Anaman-Torgbor
- Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
| | - David Adedia
- Department of Basic Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Mathias Todzro-Agudze
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | | | - Anthony Kuug
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Hadiru Mumuni
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Frank Baiden
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Sea HyoJung
- Department of Medical Law and Ethics, Graduate School, College of Medicine, Yonsei University, Seoul, 03722, Korea
- Asian Institute for Bioethics and Health Law (WHO Collaborating Centre for Health Law & Bioethics Researcher), Yonsei University Health Systems, 50-1 Yonsei-Ro, Seodaemungu-Gu, Seoul, Korea
| | - Soyoon Kim
- Asian Institute for Bioethics and Health Law (WHO Collaborating Centre for Health Law & Bioethics Researcher), Yonsei University Health Systems, 50-1 Yonsei-Ro, Seodaemungu-Gu, Seoul, Korea
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10
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Thorne T, Leicht AS. Psycho-physical demands of Traditional Indigenous Games played by Aboriginal and Torres Strait Islander women. J Sci Med Sport 2025:S1440-2440(25)00064-7. [PMID: 40090777 DOI: 10.1016/j.jsams.2025.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Revised: 02/12/2025] [Accepted: 03/01/2025] [Indexed: 03/18/2025]
Abstract
This study examined the psycho-physical demands experienced by Aboriginal and Torres Strait Islander women during several Traditional Indigenous Games (TIGs). Women engaged in three TIGs (Kai Wed, Ilye, Edor) with psycho-physical demands (i.e. heart rate; movement distance and speed; rating of perceived exertion, RPE) recorded. Significant differences were noted between TIGs with Ilye inducing greater maximum and average heart rate (5-14 %), absolute and relative distances (146-282 %), speed (3-29 %) and lower RPE (48 %) compared to Kai wed and/or Edor. Results will guide future, culturally relevant interventions to improve physical activity levels and health outcomes for Aboriginal and Torres Strait Islander women.
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Affiliation(s)
- Tiana Thorne
- Sport and Exercise Science, James Cook University, Australia. https://www.linkedin.com/in/tiana-thorne-6ba462233/
| | - Anthony S Leicht
- Sport and Exercise Science, James Cook University, Australia; Australian Institute of Tropical Health & Medicine, James Cook University, Australia.
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11
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Hansen K. From Surviving to Thriving: A Roadmap for Reinventing Cardiac Rehabilitation in Pediatric Congenital Heart Disease. Can J Cardiol 2025; 41:375-385. [PMID: 39603342 DOI: 10.1016/j.cjca.2024.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 11/11/2024] [Accepted: 11/12/2024] [Indexed: 11/29/2024] Open
Abstract
Exercise is an essential component of the cardiac care of children with congenital heart disease (CHD), and safe and effective exercise counselling by the medical team is important early in life to develop positive physical activity and exercise habits. Without it, children are at risk for sedentariness and related comorbidities in childhood and adulthood. Pediatric cardiologists can guide patients to a cycle of positive fitness through exercise counselling, promotion, prescription, and/or supervised exercise training similar to adult cardiac rehabilitation (ACR). ACR has improved exercise capacity, mortality, and quality of life in adults with acquired heart disease. Similar outcomes have been shown in exercise training for adult and pediatric CHD. Exercise training specific to pediatric CHD is not widely available but is expanding in response to growing need and increasing demand. Although ACR provides a framework for structured exercise training, approaches to pediatric exercise training must be individualized and innovated upon to be successful for children. I propose that the ACR model must be reinvented for children with CHD by integrating 6 missing pieces. First, the underlying goal should be to optimize fitness, not rehabilitate to a previous state of health. Second and third are training mental skills and motor skills. Fourth, play-based exercise training is needed to foster a positive relationship with exercise. Fifth, family-focused exercise interventions can address root causes of sedentariness. Finally, building communities in which positive fitness is a priority will be essential to long-term sustainability.
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Affiliation(s)
- Katherine Hansen
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas, USA.
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12
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Mok Y, Ballew SH, Schrack JA, Howard CM, Butler KR, Wagenknecht L, Coresh J, Budoff M, Tanaka H, Blaha MJ, Matsushita K. Mid-life physical activity and calcification of coronary arteries, aorta, and cardiac valves in late life: The Atherosclerosis Risk in Communities (ARIC) study. Atherosclerosis 2025; 402:119115. [PMID: 39922082 PMCID: PMC11890941 DOI: 10.1016/j.atherosclerosis.2025.119115] [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: 08/20/2024] [Revised: 12/20/2024] [Accepted: 01/26/2025] [Indexed: 02/10/2025]
Abstract
BACKGROUND AND AIMS The association of physical activity (PA) with coronary artery calcification (CAC), one of the strongest predictors of cardiovascular disease, is unclear. Moreover, different domains of PA (e.g., exercise/sports vs. work) and extra-coronary calcification (ECC) have not been extensively studied. We comprehensively evaluated the association of PA with CAC and ECC. METHODS We investigated 2025 ARIC participants (age 73-95 years) without coronary heart disease at visit 7 (2018-19). Mid-life total and domain-specific (sport, leisure, and work) PA scores were estimated using a modified Baecke questionnaire. We modeled the averaged PA scores at visit 1 (1987-89; age 44-65 years) and visit 3 (1993-95; age 49-70 years). We explored continuous CAC and ECC (log-transformed [Agatston score+1]) or the presence of any CAC and ECC (Agatston score >0 vs. 0) as dependent variables using multivariable linear regression and logistic regression models, as appropriate. RESULTS Total PA scores showed a U-shaped association with both continuous and any vs. no CAC. Higher total PA scores were associated inversely with ECC and most pronounced for the descending aorta calcification. The associations were generally consistent across demographic subgroups. When specific PA domains were examined, higher sport and work PA scores were significantly associated with lower descending aorta calcification. CONCLUSIONS Mid-life PA showed a U-shaped association with late-life CAC. Among ECC, the association of higher PA with lower calcification of the descending aorta was the most consistent. Our results further corroborate a complex interplay between PA and vascular health and unique pathological processes across different vascular beds.
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Affiliation(s)
- Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shoshana H Ballew
- Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Lynne Wagenknecht
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Josef Coresh
- Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Matthew Budoff
- Endowed Chair of Preventive Cardiology, Lundquist Institute, USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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13
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Zhou T, Yuan C, Shen C, Chen S, Li J, Huang K, Yang X, Liu X, Cao J, Yu L, Zhao Y, Wu X, Zhao L, Li Y, Hu D, Huang J, Gu D, Lu X, Liu F. Association between physical activity and incident atherosclerotic cardiovascular disease is modified by predicted cardiovascular risk: The China-PAR project. JOURNAL OF SPORT AND HEALTH SCIENCE 2025:101031. [PMID: 39993710 DOI: 10.1016/j.jshs.2025.101031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 11/25/2024] [Accepted: 01/03/2025] [Indexed: 02/26/2025]
Abstract
BACKGROUND It remains unclear whether the cardiovascular benefits of physical activity (PA) vary across populations with different predicted atherosclerotic cardiovascular disease (ASCVD) risks. This study aimed to determine the modification of predicted cardiovascular risk on the association between PA and ASCVD incidence. METHODS A total of 94,734 participants without ASCVD in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project were included, with a median follow-up of 6.0 years. PA volume (metabolic equivalent of task (MET)-h/day) and intensity (%, percentage of moderate-to-vigorous PA (MVPA)) were assessed by questionnaires. Based on the ASCVD 10-year and lifetime risk prediction scores, participants were classified into low-to-medium-risk and high-risk groups. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) for ASCVD were calculated using Cox proportional hazards models. RESULTS During 679,438 person-years of follow-up, 3470 ASCVD events occurred. Higher PA volume was associated with lower ASCVD incidence, which was more pronounced among high-predicted-risk individuals than their low-to-medium-risk counterparts, with HRs (95%CIs) of 0.58 (0.50-0.67) and 0.62 (0.53-0.71) for the highest vs. lowest quartiles of PA volume, respectively. Additionally, analyses for PA intensity showed similar results. Compared with inactive individuals, there was a 32% (95%CI: 25%-38%) and 23% (95%CI: 13%-32%) risk reduction in high- and low-to-medium-risk groups, respectively, when over half of the PA volume was from MVPA. Furthermore, the additive interactions between PA and predicted risk indicated a further risk reduction by increasing PA, especially MVPA, in high-risk individuals. CONCLUSION Engaging in more PA, especially MVPA, reduced the risk of ASCVD incidence, with greater benefits among high-risk individuals. These findings emphasize the imperative for personalized PA recommendations tailored to distinct risk populations-in particular, reinforcing PA guidance for high-risk individuals.
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Affiliation(s)
- Tao Zhou
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Chenxi Yuan
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Affiliated Jinling Hospital of Nanjing Medical University, General Hospital of Eastern Theater Command, Nanjing 210016, China
| | - Chong Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health; Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China.
| | - Fangchao Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China.
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14
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Ghazavi S, Zavar R, Sadeghi M, Amirpour A, Amerizadeh A. Comparing the Effect of Moderate-Intensity Versus High-Intensity Interval Training Exercise on Global Longitudinal Strain (GLS) in Cardiovascular Patients: Systematic Review and Meta-Analysis. Cardiol Res Pract 2025; 2025:9901472. [PMID: 39963426 PMCID: PMC11832266 DOI: 10.1155/crp/9901472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/04/2024] [Accepted: 01/08/2025] [Indexed: 02/20/2025] Open
Abstract
Left ventricular global longitudinal strain (LVGLS) is a highly sensitive echocardiographic biomarker that detects signs of myocardial dysfunction. It has been proven that exercise-based cardiac rehabilitation (CR) improves LV-GLS but whether high-intensity interval training (HIIT) is more efficient than moderate-intensity interval training (MIIT) to improve LV-GLS as cardiac deformation index in cardiovascular patients is debatable. In the current systematic review and meta-analysis, different digital databases including PubMed, Scopus, Web of Science (ISI), and Google Scholar were searched systematically with no time restriction to answer the abovementioned question. Studies were included that reported GLS as the outcome in CVD subjects before and after enrolling in HIIT and/or MITT. A random effects model was used for meta-analysis. Eleven sets of results from nine articles-two of which had two sets of results-were included. The result of the sensitivity test to check the publication bias was not significant either for MIIT (p=0.211) or for HIIT (p=0.238). Our findings showed that GLS was improved significantly after both MIIT (-1.72. [-2.68, -0.77]) and HIIT (-1.86 [-3.01, -0.71]) in CVD patients; however, the effect of HIIT was greater than MIIT. Subgroup analysis results showed that baseline disease and duration of exercises do not influence the effect of training on GLS. More studies are needed to confirm the conclusion.
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Affiliation(s)
- Saeed Ghazavi
- Department of Cardiac Rehabilitation, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reihaneh Zavar
- Department of Cardiac Rehabilitation, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Department of Cardiac Rehabilitation, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afshin Amirpour
- Department of Cardiac Rehabilitation, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atefeh Amerizadeh
- Department of Cardiac Rehabilitation, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Liu J, Kim JH. The effects of nordic walking on the cardiovascular risk factors in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2025; 129:105663. [PMID: 39476525 DOI: 10.1016/j.archger.2024.105663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 09/22/2024] [Accepted: 10/15/2024] [Indexed: 12/12/2024]
Abstract
OBJECTIVE This study aimed to investigate the effects of Nordic walking on cardiovascular risk factors in the elderly population through a systematic review and meta-analysis of randomized controlled trials. METHODS Literature searches were conducted in PubMed, Embase, Cochrane Library, and Web of Science through November 2023. Two authors independently assessed heterogeneity in subgroups, performed sensitivity and meta-regression analyses, and extracted data. Outcomes were measured using mean difference (MD) or standardized mean difference (SMD), each with a corresponding 95 % confidence interval (CI). RESULTS A total of 22 studies comprising 1,271 subjects, with an average age of 62.21±7.76 years were included in the meta-analysis. Nordic walking significantly reduced body mass index (MD = -0.67, 95 % CI [-1.12; -0.23], p < 0.01), body weight (MD = -1.76, 95 % CI [-2.91; -0.62], p < 0.01), waist circumference (MD = -2.21, 95 % CI [-4.13; -0.29], p = 0.02), and body fat percentage (MD = -1.54, 95 % CI [-2.61; -0.48], p < 0.01). It also significantly enhanced maximal oxygen consumption (SMD = 0.60, 95 % CI [0.11; 1.10], p < 0.01), and reduced systolic blood pressure (MD = -2.92, 95 % CI [-5.23; -0.60], p < 0.01), low-density lipoprotein (SMD = -0.27, 95 % CI [-0.43; -0.12], p < 0.01), total cholesterol (SMD = -0.20, 95 % CI [-0.35; -0.05], p < 0.01), triglycerides (SMD = -0.30, 95 % CI [-0.47; -0.13], p < 0.01) in older adults, while also improving diastolic blood pressure in people over 65 years of age (MD =-5.26, [-8.79,-1.72], p < 0.01). CONCLUSIONS Nordic walking mitigates cardiovascular risk factors in older adults and is particularly effective in improving diastolic blood pressure in individuals over 65 years of age.
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Affiliation(s)
- Jiao Liu
- Major in Sport Science, Division of Sport Industry and Science, College of Performing Arts and Sport, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, Republic of Korea
| | - Jong-Hee Kim
- Major in Sport Science, Division of Sport Industry and Science, College of Performing Arts and Sport, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, Republic of Korea.
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16
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Sara JDS, Rajai N, Ahmad A, Breuer L, Olson T, Kemmler W, Nagai T, Schilaty N, Lerman A. Physical training augmented with whole body electronic muscle stimulation favorably impacts cardiovascular biomarkers in healthy adults - A pilot randomized controlled trial. Int J Cardiol 2025; 419:132706. [PMID: 39510208 DOI: 10.1016/j.ijcard.2024.132706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Revised: 10/28/2024] [Accepted: 11/04/2024] [Indexed: 11/15/2024]
Abstract
BACKGROUND Physical activity is protective against cardiovascular disease (CVD) and favorably improves CVD risk profile. However, more than 25 % of American adults report no participation in physical activity. Whole body electronic muscle stimulation (WB-EMS) training is a novel FDA-cleared technology which offers a time-efficient and adaptable method for physical training by simultaneously stimulating the main muscle groups using percutaneous electrical impulse transmission. Studies have demonstrated increased muscle mass, reduced fat mass, and improved functional capacity in sedentary individuals after training with WB-EMS, but studies evaluating the role of WB-EMS training on CVD risk profile are lacking. METHODS We performed a pilot randomized controlled trial in healthy adults randomized to physical training with versus without WB-EMS for one session of 20 min duration per week across 16-weeks. Study participants were asked to perform their usual activities but to abstain from any strength training during the study. During each training session, all study participants wore a specifically designed vest and arm and leg straps that were connected with electrical wires to the WB-EMS device (Miha Bodytec Gersthofen, Germany). Biphasic electrical stimulation was delivered through the vest and straps (4 s on, 4 s off) at a frequency that elicited a score of 5 or 6 on the Borg rating of perceived exertion scale from study participants when each of the following muscle groups was stimulated: thighs, buttocks, lower back, upper back, latissimus dorsi, abdomen, chest and arms. These frequencies were 'titrated' during the first 4 weeks and were then fixed at each muscle group for each participant. Individuals randomized to no WB-EMS wore the same equipment but received no electrical stimulation. Physical training sessions were provided by personal trainers certified for WB-EMS training and consisted of a fixed number of exercises and repetitions. We measured and compared several clinically important cardiovascular parameters at baseline and post-intervention. RESULTS Seventy-eight participants were recruited between January 2021 and March 2022 with a mean age of 35.9 ± 11.2, 61.3 % females, median BMI 24.3 (21.8, 28.1); N = 46 were randomized to intervention group and N = 32 were randomized to the control group. Eighteen (23 %) participants dropped out of the trial, including 9 participants from the EMS arm (19.6 %), and 9 participants in control arm (28.1 %). There was no significant differences in the rate of dropping out of the WB-EMS and control groups (p = 0.27). Those in the intervention group compared to controls exhibited the following changes after 16-weeks of training: waist:hip ratio (∆ -0.03 ± 0.05, p = 0.01 vs. -0.01 ± 0.0, p = 0.1), peripheral endothelial function, measured using reactive hyperemia peripheral arterial tonometry (∆: 0.02 ± 0.1, p = 0.5 vs. -0.20 ± 0.3 p = 0.05), high-sensitivity C-reactive protein (∆: 0.06 ± 0.7, p = 0.3 vs. 0.20 ± 2.3 p = 0.02), total cholesterol (∆: -1.7 ± 25.1, p = 0.3 vs. 19.2 ± 26.5, p < 0.001), high density lipoprotein (∆: 2.02 ± 6.6, p = 0.2 vs. 3.6 ± 7.5 p = 0.01) and low density lipoprotein cholesterol (∆: 0.5 ± 26.7, p = 0.4 vs. 17.1 ± 23.2, p < 0.001). CONCLUSION Once weekly physical training with WB-EMS in healthy adults resulted in either improved or stable biomarkers of cardiovascular risk, which either remained stable or worsened in those undergoing conventional training alone. Thus WB-EMS may provide an effective and time-efficient form of physical training that may be considered in those unable or unwilling to perform exercise conventionally.
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Affiliation(s)
| | - Nazanin Rajai
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Ali Ahmad
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Logan Breuer
- Division of Sports Medicine, Mayo Clinic, Rochester, MN, USA
| | - Thomas Olson
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nurnburg, Henkestrasse, Erlangen, Germany
| | - Takashi Nagai
- United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Nathan Schilaty
- Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, FL, USA
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
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17
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Almutairi M, Almutairi AA, Alodhialah AM. The Influence of Lifestyle Modifications on Cardiovascular Outcomes in Older Adults: Findings from a Cross-Sectional Study. Life (Basel) 2025; 15:87. [PMID: 39860027 PMCID: PMC11767055 DOI: 10.3390/life15010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Revised: 01/03/2025] [Accepted: 01/08/2025] [Indexed: 01/27/2025] Open
Abstract
Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among older adults. Lifestyle modifications, including diet, physical activity, and smoking cessation, are key to reducing cardiovascular risk. This study examines the combined effects of these behaviors on cardiovascular outcomes and their mediating mechanisms. Methods: A cross-sectional study was conducted among older adults (aged ≥ 60 years) in Riyadh, Saudi Arabia. Data on dietary quality, physical activity, and smoking status were collected using validated questionnaires. Cardiovascular outcomes, including low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), and body mass index (BMI), were measured. A composite cardiovascular risk score was computed. Path analysis was employed to assess direct and indirect effects of lifestyle factors on cardiovascular outcomes. Results: Participants adhering to a healthy diet, engaging in regular physical activity, and avoiding smoking had significantly lower composite cardiovascular risk scores. Non-smoking status showed the strongest direct effect (β = -0.20, p = 0.006), while dietary quality and physical activity exhibited significant indirect effects mediated by LDL, SBP, and BMI. Combined adherence to multiple healthy behaviors resulted in the greatest reductions in cardiovascular risk. The path analysis highlighted dietary quality and physical activity as critical mediators of cardiovascular health improvements. Conclusions: Lifestyle modifications significantly reduce cardiovascular risk in older adults, with cumulative benefits observed for combined adherence to healthy behaviors. These findings emphasize the importance of comprehensive lifestyle interventions targeting diet, physical activity, and smoking cessation to promote cardiovascular health in aging populations.
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Affiliation(s)
- Mohammed Almutairi
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ashwaq A. Almutairi
- School of Nursing & Midwifery, Monash University, Melbourne, VIC 3004, Australia;
| | - Abdulaziz M. Alodhialah
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia;
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18
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Kjertakov M, Petersen A. Hot Water Immersion as a Means to Prevent Cardiovascular Disease and Associated Mortality. Curr Cardiol Rev 2025; 21:e1573403X319557. [PMID: 39185640 PMCID: PMC12060910 DOI: 10.2174/011573403x319557240822094347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 08/05/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024] Open
Abstract
Physical activity is widely promoted as a preventive strategy against cardiovascular disease and death from this disease. However, the fact that some individuals are unable or unwilling to engage in physical activity highlights the need for alternative strategies. Passive heat exposure using hot water immersion could serve as an alternative to physical exercise, as it provides similar, if not greater, cardioprotection than physical activity. This perspective article presents evidence supporting our concept and provides recommendations for hot water immersion sessions.
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Affiliation(s)
- Metodija Kjertakov
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Aaron Petersen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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19
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Ye Z, Xie J, Ni X, Yang J, Li J, Xuan Y, Gu H. Physical activity and risk of cholelithiasis: a narrative review. Front Med (Lausanne) 2024; 11:1485097. [PMID: 39736973 PMCID: PMC11682901 DOI: 10.3389/fmed.2024.1485097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 11/18/2024] [Indexed: 01/01/2025] Open
Abstract
Cholelithiasis, commonly known as gallstone disease, poses a significant public health concern globally, with a myriad of risk factors contributing to its development. Among these, lifestyle factors, particularly physical activity, have garnered considerable attention for their potential role in modulating the risk of gallstone formation. This review aims to synthesize the current landscape of physical activity and the risk of developing cholelithiasis and identify knowledge gaps. To identify relevant articles, an independent author conducted a literature search using the PubMed database including keywords "cholelithiasis," "gallstones," and "physical activity" with no restriction on publication date. Cohort studies or Mendelian randomization analyses that reported physical activity and risk of gallstone disease were included in the current review. 15 articles were included in this review. The review highlights evidence suggesting a protective effect of regular physical activity against the development of gallstones. Results of Mendelian randomization analyses similarly demonstrated that physical activity remains independently causally associated with cholelithiasis. This review underscores the potential of physical activity as a modifiable risk factor for cholelithiasis, advocating for further research to establish definitive guidelines for prevention through lifestyle modification.
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Affiliation(s)
| | | | | | | | | | | | - Honggang Gu
- Department of General Surgery A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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20
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Jung W, Cho IY, Jung J, Cho MH, Koo HY, Park YMM, Han K, Shin DW. Changes in Physical Activity and Cardiovascular Disease Risk in Cancer Survivors: A Nationwide Cohort Study. JACC CardioOncol 2024; 6:879-889. [PMID: 39801643 PMCID: PMC11711819 DOI: 10.1016/j.jaccao.2024.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 09/11/2024] [Accepted: 09/23/2024] [Indexed: 01/16/2025] Open
Abstract
Background Cancer survivors face an elevated risk of cardiovascular disease, with physical inactivity after cancer treatment potentially worsening this risk. Objectives The aim of this study was to investigate the association between physical activity before and after a cancer diagnosis and the risk for heart disease. Methods A nationwide cohort of 269,943 cancer survivors (mean age 56.3, 45.7% men) was evaluated for physical activity adherence 2 years before and after diagnosis. The primary outcomes were the incidence of myocardial infarction (MI), heart failure (HF), and atrial fibrillation. Subdistribution HRs (sHRs) and 95% CIs were calculated using Gray's method, accounting for death as a competing risk. Results Over a follow-up period of 1,111,329.28 person-years, compared with those who remained inactive, persistent physical activity was associated with a 20% reduction in MI risk (sHR: 0.80; 95% CI: 0.70-0.91) and a 16% reduction risk in HF risk (sHR: 0.84; 95% CI: 0.78-0.90). Initiating physical activity after a cancer diagnosis was linked to an 11% lower risk for MI (sHR: 0.89; 95% CI: 0.79-0.99) and a 13% lower risk for HF (sHR: 0.87; 95% CI: 0.82-0.93). Being active only before diagnosis was associated with a 20% lower risk for MI (sHR: 0.80; 95% CI: 0.71-0.91) and a 6% lower risk for HF (sHR: 0.94; 95% CI: 0.88-1.00). No association was observed between physical activity and atrial fibrillation risk. Associations varied by primary cancer site. Conclusions These findings underscore the importance of maintaining physical activity for cardiovascular health in cancer survivors and suggest that physical activity before a diagnosis may offer enduring protection against ischemic heart disease and cardiac dysfunction.
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Affiliation(s)
- Wonyoung Jung
- Department of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - In Young Cho
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jinhyung Jung
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi Hee Cho
- Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yong-Moon Mark Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Center for Trend Sensing-Risk Modeling, Institute of Quality of Life in Cancer, Samsung Medical Center, Seoul, Republic of Korea
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Romeo B, Bergami M, Cenko E, Manfrini O, Bugiardini R. Sex Disparities in Ischemic Heart Disease Mortality in Europe. JACC. ADVANCES 2024; 3:101252. [PMID: 39817073 PMCID: PMC11733970 DOI: 10.1016/j.jacadv.2024.101252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/09/2024] [Accepted: 08/12/2024] [Indexed: 01/03/2025]
Abstract
Background Ischemic heart disease (IHD) is the leading cause of death in the European Union (EU). Understanding variations by sex, income, and countries can help in tailoring effective public health policies. Objectives The purpose of the study was to examine trends in sex differences in IHD prevalence and prognosis within the EU. Methods We conducted a cross-sectional analysis of IHD using the Global Burden of Disease Study Database to examine trends in sex-specific age-standardized mortality rate (ASMR)-to-age-standardized prevalence rate (ASPR) ratio (ASMR-to-ASPR index) per 100,000 inhabitants/year across the EU from 2005 to 2019. Results Men showed higher ASMR than women. However, the ASMR-to-ASPR index was notably higher in women than in men indicating that women who develop IHD have a higher risk of dying from the disease compared with their male counterparts. Despite a significant decline in ASMR across EU from 2005 to 2019 both among women (from 1.752 to 1.662) and men (from 3.372 to 3.135), sex disparities in ASMR-to-ASPR index (EU average: 4.96% vs 4.34%) persisted (with a women-to-men ratio ranging from 1.05 to 1.44). No significant relationship was found between country-specific ASMR or country income status and ASMR-to-ASPR index. Examples include Romania, which displayed higher ASMR (men: 219.87, women: 143.54) compared with Germany (men: 107.22, women: 60.76), yet with smaller differences in ASMR-to-ASPR index between women and men (Romania: 6.54% vs 5.85%; ratio: 1.12, and Germany: 4.79% vs 3.80%; ratio: 1.26). Conclusions Mortality from IHD has decreased substantially among EU countries. However, the declines were accompanied by a persistently higher ASMR-to-ASPR index in women, indicating significant potential for further gains in closing the gender gap in IHD mortality.
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Affiliation(s)
- Benedetta Romeo
- Laboratory of Epidemiological and Clinical Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Maria Bergami
- Laboratory of Epidemiological and Clinical Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Edina Cenko
- Laboratory of Epidemiological and Clinical Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Olivia Manfrini
- Laboratory of Epidemiological and Clinical Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola Hospital, Bologna, Italy
| | - Raffaele Bugiardini
- Laboratory of Epidemiological and Clinical Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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22
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Rivera K, Gonzalez L, Bravo L, Manjarres L, Andia ME. The Gut-Heart Axis: Molecular Perspectives and Implications for Myocardial Infarction. Int J Mol Sci 2024; 25:12465. [PMID: 39596530 PMCID: PMC11595032 DOI: 10.3390/ijms252212465] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 11/15/2024] [Accepted: 11/19/2024] [Indexed: 11/28/2024] Open
Abstract
Myocardial infarction (MI) remains the leading cause of death globally, imposing a significant burden on healthcare systems and patients. The gut-heart axis, a bidirectional network connecting gut health to cardiovascular outcomes, has recently emerged as a critical factor in MI pathophysiology. Disruptions in this axis, including gut dysbiosis and compromised intestinal barrier integrity, lead to systemic inflammation driven by gut-derived metabolites like lipopolysaccharides (LPSs) and trimethylamine N-oxide (TMAO), both of which exacerbate MI progression. In contrast, metabolites such as short-chain fatty acids (SCFAs) from a balanced microbiota exhibit protective effects against cardiac damage. This review examines the molecular mediators of the gut-heart axis, considering the role of factors like sex-specific hormones, aging, diet, physical activity, and alcohol consumption on gut health and MI outcomes. Additionally, we highlight therapeutic approaches, including dietary interventions, personalized probiotics, and exercise regimens. Addressing the gut-heart axis holds promise for reducing MI risk and improving recovery, positioning it as a novel target in cardiovascular therapy.
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Affiliation(s)
- Katherine Rivera
- Doctoral Program in Medical Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 8331010, Chile;
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 7820436, Chile
- Millennium Institute for Intelligent Healthcare Engineering iHEALTH, Santiago de Chile 7820436, Chile
| | - Leticia Gonzalez
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 7820436, Chile
- Millennium Institute for Intelligent Healthcare Engineering iHEALTH, Santiago de Chile 7820436, Chile
| | - Liena Bravo
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 7820436, Chile
- Millennium Institute for Intelligent Healthcare Engineering iHEALTH, Santiago de Chile 7820436, Chile
| | - Laura Manjarres
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 7820436, Chile
- Millennium Institute for Intelligent Healthcare Engineering iHEALTH, Santiago de Chile 7820436, Chile
| | - Marcelo E. Andia
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile 7820436, Chile
- Millennium Institute for Intelligent Healthcare Engineering iHEALTH, Santiago de Chile 7820436, Chile
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23
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Peng S, Yu L, Gao Y, Dong S, Bai Y, Li G, Liang C, Tian Z, Lv C, Zhou F, Wei Y, Wang G, Li L, Hao G. Association of objectively measured walking speed with incident cardiovascular diseases in middle-aged and older Chinese adults. Hellenic J Cardiol 2024; 80:47-54. [PMID: 39491219 DOI: 10.1016/j.hjc.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 11/05/2024] Open
Abstract
OBJECTIVE To evaluate the association between objectively measured walking speed and cardiovascular disease (CVD) risk in middle-aged and elderly Chinese adults. METHODS A total of 3969 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included in this study. Multilevel logistic and linear regression models (community-household-individual) were used to estimate the association between walking speed and the risk of CVD. RESULTS A total of 1037 participants had a CVD event during the follow-up period, including 776 (19.6%) cases of cardiac disease and 353 (8.9%) cases of stroke. Participants who walked faster had a lower risk of CVD (tertile 2: OR = 0.80, 95% CI: 0.67-0.97, P = 0.022; tertile 3: OR = 0.73, 95% CI: 0.60-0.89, P = 0.002). Further analysis showed that participants who walked faster also had a lower risk of cardiac disease and stroke (cardiac disease: tertile 2: OR = 0.91, 95% CI: 0.74-1.12, P = 0.368; tertile 3: OR = 0.85, 95% CI: 0.68-1.07, P = 0.161; stroke: tertile 2: OR = 0.33, 95% CI: 0.14-0.78, P = 0.012; tertile 3: OR = 0.30, 95% CI: 0.11-0.82, P = 0.019). The results were consistent in pre-specified subgroups by sex, age, and body mass index. CONCLUSION We found that faster, objectively measured walking speed was significantly associated with a lower risk of CVD, especially stroke, in middle-aged and elderly Chinese people.
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Affiliation(s)
- Shuang Peng
- School of Sport and Health Sciences, Guangzhou Sport University, Guangzhou 510500, China; Key Laboratory of Sports Technique, Tactics, and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou 510500, China.
| | - Lei Yu
- Department of Pathophysiology, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yuhua Gao
- School of Athletic Training, Guangzhou Sport University, Guangzhou 510500, China
| | - Shan Dong
- Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou 510180, China
| | - Yuhui Bai
- Key Laboratory of Sports Technique, Tactics, and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou 510500, China
| | - Guojun Li
- School of Sport and Health Sciences, Guangzhou Sport University, Guangzhou 510500, China
| | - Changxue Liang
- Key Laboratory of Sports Technique, Tactics, and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou 510500, China
| | - Zhuoyao Tian
- Key Laboratory of Sports Technique, Tactics, and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou 510500, China
| | - Changsheng Lv
- School of Sport and Health Sciences, Guangzhou Sport University, Guangzhou 510500, China
| | - Fu Zhou
- Key Laboratory of Sports Technique, Tactics, and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou 510500, China
| | - Yuan Wei
- Key Laboratory of Sports Technique, Tactics, and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou 510500, China
| | - Ge Wang
- Volleyball Teaching and Research Office of Sports Training Institute, Guangzhou Sport University, Guangzhou 510500, China.
| | - Liangming Li
- School of Sport and Health Sciences, Guangzhou Sport University, Guangzhou 510500, China; Key Laboratory of Sports Technique, Tactics, and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou 510500, China.
| | - Guang Hao
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
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24
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Hansen RK, Laessoe U, Samani A, Mellergaard M, Rasmussen RW, Handberg A, Larsen RG. Impact of upper-body ergometer rowing exercise on aerobic fitness and cardiometabolic disease risk in individuals with spinal cord injury: A 6-month follow-up study. J Spinal Cord Med 2024; 47:996-1006. [PMID: 37534922 PMCID: PMC11533236 DOI: 10.1080/10790268.2023.2233820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
Objective: We recently demonstrated that upper-body rowing exercise (UBROW) improved aerobic fitness in individuals with spinal cord injury (SCI), with no effect on traditional cardiometabolic risk factors. Here, we tested the hypothesis that the exercise-induced increase in aerobic fitness was maintained at 6-month (6M) follow-up.Design: Six-month follow-up.Setting: University/hospital.Participants: Seventeen wheelchair-dependent participants with SCI.Interventions: 12-week of exercise training (UBROW) or control (CON).Outcome Measures: Aerobic fitness (POpeak and V̇O2peak), body composition, blood pressure, and blood biomarkers of cardiometabolic risk were assessed at 6M follow-up and compared to baseline (BL) and immediately post-intervention (12-week). Minutes of mild, moderate, and heavy intensity leisure time physical activity (LTPA) were assessed by self-report.Results: Fourteen participants returned at 6M follow-up (CON, n = 6; UBROW, n = 8). In UBROW, POpeak (median (Q1-Q3)) increased from BL (70 W (37-84)) to 12-week (77 W (58-109), P = 0.01) and 6M follow-up (81 W (51-96), P = 0.01), with no difference between 12-week and 6M follow-up (P = 0.21). Similarly, V̇O2peak increased from BL (15.4 ml/kg/min (10.5-19.4)) to 12-week (16.6 ml/kg/min (12.8-21.3), P = 0.01) with no difference between 12-week and 6M follow-up (16.3 ml/kg/min (12.9-19.7), P = 0.74). No differences were found in CON for either POpeak (P = 0.22) or V̇O2peak (P = 0.27). There were no changes over time in traditional cardiometabolic risk factors or for minutes of different LTPA intensities.Conclusion: We demonstrate that improvements in aerobic fitness are maintained for at least six months after completion of a 12-week exercise intervention, supporting the use of periodic exercise interventions to boost aerobic fitness level in individuals with SCI.Trial registration: ClinicalTrials.gov identifier: NCT04390087..
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Affiliation(s)
- Rasmus Kopp Hansen
- ExerciseTech, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Department of Research and Development, University College of Northern Jutland, Aalborg, Denmark
| | - Uffe Laessoe
- Department of Research and Development, University College of Northern Jutland, Aalborg, Denmark
| | - Afshin Samani
- ExerciseTech, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Maiken Mellergaard
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Aase Handberg
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ryan Godsk Larsen
- ExerciseTech, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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25
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Singh M, Singh S, Pandey MK, Singh S. Exploring the link between physical activity and cardiovascular disease among Indian elderly: Evidence from the Longitudinal Aging Study in India(LASI). Curr Probl Cardiol 2024; 49:102778. [PMID: 39089412 DOI: 10.1016/j.cpcardiol.2024.102778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Cardiovascular disease (CVD) remains a leading cause of mortality and morbidity globally, particularly among older adults. In India, the rapid demographic transition has resulted in a significant increase in the aging population, necessitating a deeper understanding of the factors influencing CVD prevalence. This study examines the association between physical activity and the prevalence of CVD among individuals aged 60 and above. DATA & METHODS This study utilized cross-sectional data from the LASI-Wave 1, comprising a nationally representative sample of 28,935 individuals. Logistic regression analysis was employed to investigate the relationship between physical activity and CVD. Population Attributable Factor (PAF) was calculated to determine the proportion of CVD cases preventable by recommended physical activity levels. RESULTS Adequate physical activity significantly lowered the risk of CVD by 28% (OR 0.72, 95% CI 0.67-0.78). Inadequate physical activity also showed a protective effect (OR 0.88, 95% CI 0.83-0.94) compared to those who were physically inactive. Other significant factors influencing CVD risk included age, sex, educational level, living arrangements, self-rated health status, body mass index, smoking habits, and multi-morbidity. The comparison between adequate physical activity levels and physically inactive shows a PAF estimate of 0.093 (95% CI: 0.071 - 0.114), indicating that 9.3% of cardiovascular disease cases could be prevented by increasing physical activity from inactive to adequate levels. CONCLUSION The findings highlight the significant role of physical activity in reducing CVD risk among older adults in India. Promoting regular physical activity through community-based programs and healthcare interventions could substantially lower the risk of CVD.
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Affiliation(s)
- Moradhvaj Singh
- Department of Yogic Sciences, Lakshmibai National Institution of Physical Education, Gwalior M P, India, 474002.
| | | | - Manoj Kumar Pandey
- Department of Physical Education, Indira Gandhi National Tribal University, Amarkantak, M P., India, 484887.
| | - Saurabh Singh
- International Institute for Population Sciences, Mumbai, Maharashtra, India, 400088.
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Ashton L, Beh BA, Burke M, Cullen R, Czerenkowski J, Davey J, Dennett AM, English K, Godecke E, Harper N, Lynch E, MacDonald-Wicks L, Patterson A, Ramage E, Schelfhaut B, Simpson DB, Zacharia K, English C. Adapting a Telehealth Physical Activity and Diet Intervention to a Co-Designed Website for Self-Management After Stroke: Tutorial. J Med Internet Res 2024; 26:e58419. [PMID: 39437389 PMCID: PMC11538875 DOI: 10.2196/58419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/08/2024] [Accepted: 07/31/2024] [Indexed: 10/25/2024] Open
Abstract
People who experience a stroke are at a higher risk of recurrent stroke when compared with people who have not had a stroke. Addressing modifiable risk factors like physical inactivity and poor diet has been shown to improve blood pressure, a leading contributor to stroke. However, survivors of stroke often experience challenges with accessing risk reduction services including long wait lists, difficulty with transportation, fatigue, impaired function, and diminished exercise capacity. Providing health interventions via a website can extend the reach when compared with programs that are only offered face to face or via real-time telehealth. Given global challenges of accessing secondary prevention programs, it is important to consider alternative ways that this information can be made available to survivors of stroke worldwide. Using the "design thinking" framework and drawing on principles of the integrated knowledge translation approach, we adapted 2 co-designed telehealth programs called i-REBOUND - Let's get moving (physical activity intervention) and i-REBOUND - Eat for health (diet Intervention) to create the i-REBOUND after stroke website. The aim of this paper is to describe the systematic process undertaken to adapt resources from the telehealth delivered i-REBOUND - Let's get moving and i-REBOUND - Eat for health programs to a website prototype with a focus on navigation requirements and accessibility for survivors of stroke. We engaged a variety of key stakeholders with diverse skills and expertise in areas of stroke recovery, research, and digital health. We established a governance structure, formed a consumer advisory group, appointed a diverse project team, and agreed on scope of the project. Our process of adaptation had the following 3 phases: (1) understand, (2) explore, (3) materialize. Our approach considered the survivor of stroke at the center of all decisions, which helped establish guiding principles related to our prototype design. Careful and iterative engagement with survivors of stroke together with the application of design thinking principles allowed us to establish the functional requirements for our website prototype. Through user testing, we were able to confirm the technical requirements needed to build an accessible and easy-to-navigate website catering to the unique needs of survivors of stroke. We describe the process of adapting existing content and co-creating new digital content in partnership with, and featuring, people who have lived experience of stroke. In this paper, we provide a road map for the steps taken to adapt resources from 2 telehealth-delivered programs to a website format that meets specific navigation and accessibility needs of survivors of stroke.
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Affiliation(s)
- Lee Ashton
- Food and Nutrition Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Brian A Beh
- Consumer Advisory Group Member, Sydney, Australia
| | - Meredith Burke
- Consumer Advisory Group Member, Newcastle, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, Australia
| | | | | | - Julie Davey
- Consumer Advisory Group Member, Wangaratta, Australia
| | - Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Melbourne, Australia
- School of Allied Health, Human Services and Sport, Latrobe University, Melbourne, Australia
| | - Kevin English
- Consumer Advisory Group Member, Melbourne, Australia
| | - Erin Godecke
- Department of Speech Pathology, School of Medical and Health Sciences, Edith Cowan University, Sir Charles Gairdne Park Health Care Group, Perth, Australia
| | - Nicole Harper
- Consumer Advisory Group Member, Newcastle, Australia
| | - Elizabeth Lynch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lesley MacDonald-Wicks
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Food and Nutrition Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Amanda Patterson
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Food and Nutrition Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Emily Ramage
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- ASPIRE Unit, Western Health, Melbourne, Australia
- Institute of Neurosciences and Mental Health, Florey, Melburne, Australia
| | | | - Dawn B Simpson
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Karly Zacharia
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Food and Nutrition Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Coralie English
- School of Health Sciences, University of Newcastle, Newcastle, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, Australia
- Centre of Research Excellence to Accelerate Stroke Trial Innovation and Translation, University of Sydney, Sydney, Australia
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Le Mat Y, Casali C, Le Mat F, Féasson L, Foschia C, Géry M, Rossi J, Millet GY. Impact of a Self-Autonomous Evaluation Station and Personalized Training Algorithm on Quality of Life and Physical Capacities in Sedentary Adults: Randomized Controlled Trial. JMIR Form Res 2024; 8:e45461. [PMID: 39365990 PMCID: PMC11489803 DOI: 10.2196/45461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/05/2024] [Accepted: 06/03/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Physical inactivity is a major risk factor for noncommunicable diseases and a leading cause of premature death. The World Health Organization (WHO) recommends at least 150 minutes of moderate intensity physical activity (PA) weekly, regardless of age, gender, or personal habits. However, in both sports performance and clinical settings, personalized training (PT) regimens have shown superior efficacy over general guidelines. OBJECTIVE We hypothesized that an automatic PT program, informed by initial physical evaluations, would increase overall quality of life, quality of sleep, and physical capabilities and reduce fatigue and depression compared with adherence to WHO recommendations. METHODS This 5-month, randomized, single-blinded controlled trial involved 112 sedentary or minimally active participants, divided randomly into PT and free training (FT) groups. Physical capabilities and subjective measures such as quality of life, sleep, depression, and fatigue were evaluated for both groups. After 1 month, both groups were asked to perform 150 minutes of PA per week for 4 months; the PT group could either follow a "virtual coach" on a mobile app to follow some personalized PA or do what they would like, while the FT group was to follow the general PA recommendations of the WHO. RESULTS We did not find any group×time interaction for PA duration or intensity, physical qualities, and subjective measures. However, considering both groups together, there was a significant pretest and posttest time effect for duration of PA (18.2 vs 24.5 min/d of PA; P<.001), intensity (2.36 vs 3.11; P<.001), and workload (46.8 vs 80.5; P<.001). Almost all physical qualities were increased pretest and posttest (ie, estimated VO2max 26.8 vs 29 mL min-1 kg-1; P<.001; flexibility 25.9 vs 26.9 cm; P=.049; lower limb isometric forces 328 vs 347 N m; P=.002; reaction time 0.680 vs 0.633 s; P<.001; power output on cyclo-ergometer 7.63 vs 7.82 W; P<.003; and balance for the left and right leg 215 vs 163 mm2; P<.003 and 186 vs 162 mm2; P=.048, respectively). Finally, still considering the PT and FT groups together, there were significant pretest to posttest improvements in the mental component of quality of life using the 12-item Short Form Health Survey (41.9 vs 46.0; P<.006), well-being using the Warwick-Edinburgh Mental Well-Being Scale (48.3 vs 51.7; P<.002), depression using the Center for Epidemiologic Studies Depression Scale (15.5 vs 11.5; P=.02), and fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (37.1 vs 39.5; P=.048). CONCLUSIONS The individualized training was not more effective than the general recommendations. A slight increase in PA (from 18 to 24 min/d) in sedentary or poorly active people is enough for a significant increase in physical capabilities and a significant improvement in quality of life, well-being, depression, and fatigue. TRIAL REGISTRATION ClinicalTrials.gov NCT04998266; https://clinicaltrials.gov/study/NCT04998266.
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Affiliation(s)
- Yann Le Mat
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint Etienne, France
| | - Corentin Casali
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint Etienne, France
| | - Franck Le Mat
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint Etienne, France
| | - Léonard Féasson
- Centre Hospitalier Universitaire (CHU) Saint-Etienne, Service de Physiologie Clinique et de l'Exercice, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint Etienne, France
- Centre Hospitalier Universitaire (CHU) Saint Etienne, Centre Référent Maladies Neuromusculaires Rares - European Reference Networks (ERN EuroNmD), Saint Etienne, France
| | - Clément Foschia
- Centre Hospitalier Universitaire (CHU) Saint-Etienne, Service de Physiologie Clinique et de l'Exercice, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint Etienne, France
| | - Mathias Géry
- Université Jean Monnet Saint-Etienne, Centre National de la Recherche Scientifique (CNRS), Institut d'Optique Graduate School, Laboratoire Hubert Curien, Unité Mixte de Recherche (UMR) 5516, F-42023, Saint Etienne, France
| | - Jérémy Rossi
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint Etienne, France
| | - Guillaume Y Millet
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint Etienne, France
- Institut Universitaire de France (IUF), Paris, France
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Yılmaz F, Babayeva A, Yetkin İ, Boşnak-Güçlü M. Comparison of exercise capacity and physical activity in patients with hyperthyroidism and controls. J Bodyw Mov Ther 2024; 40:1752-1760. [PMID: 39593519 DOI: 10.1016/j.jbmt.2024.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/12/2024] [Accepted: 10/13/2024] [Indexed: 11/28/2024]
Abstract
BACKGROUND Hyperthyroidism impairs muscle mitochondrial metabolism and destroys many body systems. However, information is limited on how much physical and physiological outcomes are impaired in patients with newly diagnosed hyperthyroidism (NDH) and euthyroid. The comparison of pulmonary function, functional exercise capacity, respiratory muscle strength and endurance, physical activity levels (PAL), dyspnea, and quality of life (QoL) in patients and healthy controls was aimed. METHOD Sixteen patients with hyperthyroidism (evaluated twice at new diagnosis and euthyroid state) and healthy controls were compared. Pulmonary function was evaluated with a spirometer, functional exercise capacity with a 6-min walking test (6-MWT), respiratory muscle strength with a mouth pressure device and endurance with threshold loading test, PAL with metabolic holter, dyspnea with Modified Medical Research Council (MMRC) scale, and QoL with Quality of Life in Thyroid Patients Scale (ThyPRO). RESULTS Six-MWT distance and respiratory muscle endurance significantly decreased, and MMRC dyspnea scale and ThyPRO scores were higher in patients with NDH and euthyroid compared to controls (p < 0.05). In addition, maximum inspiratory pressure and maximum expiratory pressure significantly decreased in patients with NDH compared to controls, and PAL was less active according to the number of steps in euthyroid patients (p < 0.05). The pulmonary function test was similar in both groups (p > 0.05). CONCLUSION Exercise capacity, respiratory muscle strength and endurance, PAL, dyspnea, and QoL were affected in patients. Patients with hyperthyroidism should be evaluated at the onset of diagnosis, followed up, and referred to cardiopulmonary rehabilitation programs at the earliest. ClinicalTrials number: NCT04825964.
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Affiliation(s)
- Fidan Yılmaz
- Gazi University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Afruz Babayeva
- Gazi University, Faculty of Medicine, Department of Endocrinology, Ankara, Turkey.
| | - İlhan Yetkin
- Gazi University, Faculty of Medicine, Department of Endocrinology, Ankara, Turkey.
| | - Meral Boşnak-Güçlü
- Gazi University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Ankara, Turkey.
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Silva JPLN, Ribeiro F, Valente HB, Vanzella LM, Laurino MJL, do Nascimento GDSS, Moliterno AH, Tebar WR, Christofaro DGD, Vanderlei LCM. Association of sedentary behavior and physical activity with occurrence of signs and symptoms in participants of a cardiac rehabilitation program. Sci Rep 2024; 14:22738. [PMID: 39349610 PMCID: PMC11442860 DOI: 10.1038/s41598-024-74199-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 09/24/2024] [Indexed: 10/04/2024] Open
Abstract
Sedentary behavior (SB) is associated with health impairments, while physical activity (PA) has been a protective factor. It is unclear whether SB and PA are associated with occurrence of signs and/or symptoms (SS) during cardiac rehabilitation program (CRP) exercise sessions. The objective was to evaluate the association between SB and PA with occurrence of SS. Was included 48 patients from a CRP program (64.7 ± 10.4 years-old). Daily time and % of time of SB and weekly time in moderate-to-vigorous-intensity [MVPA], % of MVPA time, steps/day, and steps/minute were accelerometer-measured. Patients were followed-up during 24 CRP sessions, for accompaniment of SS. Age, sex, and comorbidities (hypertension, diabetes, dyslipidemia, obesity) were covariates. Log-transformed values of SB, MVPA and steps/day were also analyzed. As results, 43.7% (n = 21) of participants presented occurrence of signs, 62.5% (n = 30) presented occurrence of symptoms, and 81.2% (n = 39) present occurrence of SS. In fully adjusted model, % of time in MVPA (β: -0.449,p = 0.045) and steps/minute (β: -0.244,p = 0.026) were inversely associated with occurrence of symptoms. No association was observed between SB and PA and occurrence of signs. The occurrence of symptoms and SS among CRP participants was directly associated with SB and inversely associated with variables of PA.
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Affiliation(s)
- João Pedro Lucas Neves Silva
- Department of Physiotherapy, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil.
- St Roberto Simonsen, 305, Educational Center, Physiotherapy Department, São Paulo State University, School of Sciences and Technologies, Presidente Prudente, São Paulo, 19060-900, Brazil.
| | - Felipe Ribeiro
- Department of Physiotherapy, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
| | - Heloisa Balotari Valente
- Department of Physiotherapy, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
| | - Lais Manata Vanzella
- Department of Physiotherapy, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
| | - Maria Julia Lopez Laurino
- Department of Physiotherapy, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
| | | | - Alice Haniuda Moliterno
- Department of Physiotherapy, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
| | - William Rodrigues Tebar
- Department of Physical Education, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
| | - Diego Giulliano Destro Christofaro
- Department of Physical Education, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
| | - Luiz Carlos Marques Vanderlei
- Department of Physiotherapy, São Paulo State University-UNESP, School of Sciences and Technologies, Presidente Prudente, São Paulo, Brazil
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30
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Bello MO, Mammino KM, Vernon MA, Wakeman DG, Denmon CA, Krishnamurthy LC, Krishnamurthy V, McGregor KM, Novak TS, Nocera JR. Graded Intensity Aerobic Exercise to Improve Cerebrovascular Function and Performance in Older Veterans: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e58316. [PMID: 39326042 PMCID: PMC11467598 DOI: 10.2196/58316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Growing health care challenges resulting from a rapidly expanding aging population necessitate examining effective rehabilitation techniques that mitigate age-related comorbidity and improve quality of life. To date, exercise is one of a few proven interventions known to attenuate age-related declines in cognitive and sensorimotor functions critical to sustained independence. OBJECTIVE This work aims to implement a multimodal imaging approach to better understand the mechanistic underpinnings of the beneficial exercise-induced adaptations to sedentary older adults' brains and behaviors. Due to the complex cerebral and vascular dynamics that encompass neuroplastic change with aging and exercise, we propose an imaging protocol that will model exercise-induced changes to cerebral perfusion, cerebral vascular reactivity (CVR), and cognitive and sensorimotor task-dependent functional magnetic resonance imaging (fMRI) after prescribed exercise. METHODS Sedentary older adults (aged 65-80 years) were randomly assigned to either a 12-week aerobic-based interval-based cycling intervention or a 12-week balance and stretching intervention. Assessments of cardiovascular fitness used the YMCA submaximal VO2 test, basal cerebral perfusion using arterial spin labeling (ASL), CVR using hypercapnic fMRI, and cortical activation using fMRI during verbal fluency and motor tapping tasks. A battery of cognitive-executive and motor function tasks outside the scanning environment will be performed before and after the interventions. RESULTS Our studies and others show that improved cardiovascular fitness in older adults results in improved outcomes related to physical and cognitive health as well as quality of life. A consistent but unexplained finding in many of these studies is a change in cortical activation patterns during task-based fMRI, which corresponds with improved task performance (cognitive-executive and motor). We hypothesize that the 12-week aerobic exercise intervention will increase basal perfusion and improve CVR through a greater magnitude of reactivity in brain areas susceptible to neural and vascular decline (inferior frontal and motor cortices) in previously sedentary older adults. To differentiate between neural and vascular adaptations in these regions, we will map changes in basal perfusion and CVR over the inferior frontal and the motor cortices-regions we have previously shown to be beneficially altered during fMRI BOLD (blood oxygen level dependent), such as verbal fluency and motor tapping, through improved cardiovascular fitness. CONCLUSIONS Exercise is one of the most impactful interventions for improving physical and cognitive health in aging. This study aims to better understand the mechanistic underpinnings of improved health and function of the cerebrovascular system. If our hypothesis of improved perfusion and cerebrovascular reactivity following a 12-week aerobic exercise intervention is supported, it would add critically important insights into the potential of exercise to improve brain health in aging and could inform exercise prescription for older adults at risk for neurodegenerative disease brought on by cerebrovascular dysfunction. TRIAL REGISTRATION ClinicalTrials.gov NCT05932069; https://clinicaltrials.gov/study/NCT05932069. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/58316.
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Affiliation(s)
- Medina Oneyi Bello
- Joseph Maxwell Cleland Atlanta Veteran Affairs Medical Center, Decatur, GA, United States
| | - Kevin Michael Mammino
- Joseph Maxwell Cleland Atlanta Veteran Affairs Medical Center, Decatur, GA, United States
| | | | - Daniel G Wakeman
- School of Medicine, Emory University, Decatur, GA, United States
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Vine M, Daucourt C, Besson C, Neyroud D, Kayser B, Meyer P, Graf G, Gabus V, Gremeaux V, Muller O, Baggish AL. Cardiovascular risk factors among endurance masters athletes from Switzerland. Eur J Prev Cardiol 2024:zwae287. [PMID: 39302882 DOI: 10.1093/eurjpc/zwae287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Accepted: 08/27/2024] [Indexed: 09/22/2024]
Affiliation(s)
- Morgane Vine
- Department of Cardiology, Lausanne University Hospital, Rue du Bugnon 46, 1005 Lausanne, Switzerland
| | - Chantal Daucourt
- Department of Sports Medicine, Swiss Olympic Medical Center, Rue du Bugnon 46, 1005 Lausanne University Hospital, Lausanne, Switzerland
| | - Cyril Besson
- Department of Sports Medicine, Swiss Olympic Medical Center, Rue du Bugnon 46, 1005 Lausanne University Hospital, Lausanne, Switzerland
| | - Daria Neyroud
- Institute of Sports Sciences, University of Lausanne, Synathlon - Quartier Centre, 1015 Lausanne, Switzerland
| | - Bengt Kayser
- Institute of Sports Sciences, University of Lausanne, Synathlon - Quartier Centre, 1015 Lausanne, Switzerland
| | - Philippe Meyer
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Guillaume Graf
- Clinique La Lignière, La Lingière 5, 1196 Gland, Switzerland
| | - Vincent Gabus
- Departments of Cardiology, l'Hôpital Riviera Chablais, Rennaz, Switzerland
| | - Vincent Gremeaux
- Department of Sports Medicine, Swiss Olympic Medical Center, Rue du Bugnon 46, 1005 Lausanne University Hospital, Lausanne, Switzerland
- Institute of Sports Sciences, University of Lausanne, Synathlon - Quartier Centre, 1015 Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Rue du Bugnon 46, 1005 Lausanne, Switzerland
| | - Aaron L Baggish
- Department of Cardiology, Lausanne University Hospital, Rue du Bugnon 46, 1005 Lausanne, Switzerland
- Department of Sports Medicine, Swiss Olympic Medical Center, Rue du Bugnon 46, 1005 Lausanne University Hospital, Lausanne, Switzerland
- Institute of Sports Sciences, University of Lausanne, Synathlon - Quartier Centre, 1015 Lausanne, Switzerland
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Li Z, Kang S, Kang H. Development and validation of nomograms for predicting cardiovascular disease risk in patients with prediabetes and diabetes. Sci Rep 2024; 14:20909. [PMID: 39245747 PMCID: PMC11381537 DOI: 10.1038/s41598-024-71904-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/02/2024] [Indexed: 09/10/2024] Open
Abstract
This study aimed to develop and validate distinct nomogram models for assessing CVD risk in individuals with prediabetes and diabetes. In a cross-sectional study design, we examined data from 2294 prediabetes and 1037 diabetics who participated in the National Health and Nutrition Examination Survey, which was conducted in the United States of America between 2007 and 2018. The dataset was randomly divided into training and validation cohorts at a ratio of 0.75-0.25. The Boruta feature selection method was used in the training cohort to identify optimal predictors for CVD diagnosis. A web-based dynamic nomogram was developed using the selected features, which were validated in the validation cohort. The Hosmer-Lemeshow test was performed to assess the nomogram's stability and performance. Receiver operating characteristics and calibration curves were used to assess the effectiveness of the nomogram. The clinical applicability of the nomogram was evaluated using decision curve analysis and clinical impact curves. In the prediabetes cohort, the CVD risk prediction nomogram included nine risk factors: age, smoking status, platelet/lymphocyte ratio, platelet count, white blood cell count, red cell distribution width, lactate dehydrogenase level, sleep disorder, and hypertension. In the diabetes cohort, the CVD risk prediction nomogram included eleven risk factors: age, material status, smoking status, systemic inflammatory response index, neutrophil-to-lymphocyte ratio, red cell distribution width, lactate dehydrogenase, high-density lipoprotein cholesterol, sleep disorder, hypertension, and physical activity. The nomogram models developed in this study have good predictive and discriminant utility for predicting CVD risk in patients with prediabetes and diabetes.
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Affiliation(s)
- Zhao Li
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea
| | - Seamon Kang
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea.
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Jung W, Cho IY, Jung J, Cho MH, Koo HY, Park YMM, Cho BL, Kwon H, Park JH, Han K, Shin DW. Association between physical activity changes and risk of incident ischemic stroke following cancer diagnosis: A nationwide retrospective cohort study. Cancer 2024; 130:2873-2885. [PMID: 38723109 DOI: 10.1002/cncr.35361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/27/2024] [Accepted: 04/19/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Physical inactivity is prevalent after cancer treatment, which could increase ischemic stroke risk in cancer survivors. This study investigated the association between physical activity change from pre- to post-diagnosis and ischemic stroke risk among cancer survivors. METHODS Using data from the Korean National Health Insurance Service database, 269,943 cancer survivors (mean [SD] age, 56.3 [12.1] years; 45.7% male) with no history of cardiovascular disease were evaluated based on changes in physical activity from pre- to post-diagnosis. Using the Fine-Gray model, subdistribution hazard ratios (sHRs) and 95% confidence intervals (CIs) for ischemic stroke risk were calculated, considering death as a competing risk. RESULTS After cancer diagnosis, 62.0% remained inactive, 10.1% remained active, 16.6% became active, and 11.4% became inactive. During a mean (SD) follow-up of 4.1 (2.0) years, being active both pre- and post-diagnosis was associated with a 15% decreased risk of ischemic stroke (sHR, 0.85; 95% CI, 0.75-0.96), compared with those who remained inactive. Cancer survivors who became active and inactive post-diagnosis showed a 16% and 11% lower ischemic stroke risk (sHR, 0.84; 95% CI, 0.75-0.93; sHR, 0.89; 95% CI, 0.79-0.99), respectively, than those who remained inactive. Analysis by the primary cancer site did not substantially differ from the main findings. CONCLUSIONS Physical activity is associated with reduced ischemic stroke risk among cancer survivors. The potential benefits of physical activity are not limited to individuals who were physically active before cancer diagnosis, thus preventive strategies against ischemic stroke should emphasize physical activity throughout the cancer journey.
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Affiliation(s)
- Wonyoung Jung
- Department of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - In Young Cho
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Jinhyung Jung
- Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Mi Hee Cho
- Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yong-Moon Mark Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Be-Long Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Ho Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
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Pasmiño G, Paredes M, Silva H. Effects of High-Intensity Swimming Interval Training on Area, Perimeter, Circularity Index and Phenotype of Cardiac Mitochondrial Ultrastructure in Sprague Dawley Rats. Life (Basel) 2024; 14:984. [PMID: 39202726 PMCID: PMC11355701 DOI: 10.3390/life14080984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 09/03/2024] Open
Abstract
Physical inactivity impairs health by increasing morbidity. In childhood, modifiable risk factors associated with cardiovascular pathologies and related to mitochondrial function and structure are initiated by physical inactivity. The objective of this study was to analyze the effect of high-intensity swimming interval training (HIIT-swim) on cardiac mitochondrial ultrastructure in young Sprague Dawley rats compared with a sedentary group. Five-week-old Sprague Dawley rats (n = 18) were divided into a control group (C) (n = 6), a sedentary group (S) (n = 6) and an HIIT-swim group (H-s) (n = 6), the last of which performed HIIT-swim for 4 weeks. A mitochondrial ultrastructural evaluation was performed using transmission electron microscopy. In the H-s rats, mitochondrial areas and perimeters were found to be statistically significantly different from those of the C and S rats. In addition, no predominant intramitochondrial multifragmentation was observed in the mitochondria of H-s rats, but multifragmentation was evident in the mitochondria of S rats.
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Affiliation(s)
- Grace Pasmiño
- Programa de Doctorado en Ciencias Morfológicas, Facultad de Medicina, Universidad de La Frontera, Temuco 4811230, Chile;
- Laboratorio Fisiología del Ejercicio, Departamento de Ciencias Básicas, Facultad de Medicina, Universidad de La Frontera, Temuco 4811230, Chile
| | - Marco Paredes
- Laboratorio de Biología Celular, Departamento de Ciencias Básicas, Facultad de Medicina, Universidad de La Frontera, Temuco 4811230, Chile;
| | - Héctor Silva
- Laboratorio Fisiología del Ejercicio, Departamento de Ciencias Básicas, Facultad de Medicina, Universidad de La Frontera, Temuco 4811230, Chile
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Ranadive SM, Weiner CM, Eagan LE, Addison O, Landers‐Ramos RQ, Prior SJ. Arterial function in response to a 50 km ultramarathon in recreational athletes. Exp Physiol 2024; 109:1385-1394. [PMID: 38860912 PMCID: PMC11291851 DOI: 10.1113/ep091680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/29/2024] [Indexed: 06/12/2024]
Abstract
This study was performed to determine whether prolonged endurance running results in acute endothelial dysfunction and wave-reflection, as endothelial dysfunction and arterial stiffness are cardiovascular risk factors. Vascular function (conduit artery/macrovascular and resistance artery/microvascular) was assessed in 11 experienced runners (8 males, 3 females) before, during and after a 50 km ultramarathon. Blood pressure (BP), heart rate (HR), wave reflection, augmentation index (AIx) and AIx corrected for HR (AIx75) were taken at all time points-Baseline (BL), following 10, 20, 30 and 40 km, 1 h post-completion (1HP) and 24 h post-completion (24HP). Flow-mediated dilatation (FMD) and inflammatory biomarkers were examined at BL, 1HP and 24HP. Reactive hyperaemia area under the curve (AUC) and shear rate AUC to peak dilatation were lower (∼75%) at 1HP compared with BL (P < 0.001 for both) and reactive hyperaemia was higher at 24HP (∼27%) compared with BL (P = 0.018). Compared to BL, both mean central systolic BP and mean central diastolic BP were 7% and 10% higher, respectively, following 10 km and 6% and 9% higher, respectively, following 20 km, and then decreased by 5% and 8%, respectively, at 24HP (P < 0.05 for all). AIx (%) decreased following 20 km and following 40 km compared with BL (P < 0.05 for both) but increased following 40 km when corrected for HR (AIx75) compared with BL (P = 0.02). Forward wave amplitude significantly increased at 10 km (15%) compared with BL (P = 0.049), whereas backward wave reflection and reflected magnitude were similar at all time points. FMD and baseline diameter remained similar. These data indicate preservation of macrovascular (endothelial) function, but not microvascular function resulting from the 50 km ultramarathon.
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Affiliation(s)
| | - Cynthia M. Weiner
- Department of KinesiologyUniversity of MarylandCollege ParkMarylandUSA
| | - Lauren E. Eagan
- Department of KinesiologyUniversity of MarylandCollege ParkMarylandUSA
| | - Odessa Addison
- Department of Physical Therapy and Rehabilitation ScienceUniversity of MarylandBaltimoreMarylandUSA
- Department of Veterans Affairs and Veterans Affairs Medical Center, Geriatric ResearchEducation and Clinical CenterBaltimoreMarylandUSA
| | | | - Steven J. Prior
- Department of KinesiologyUniversity of MarylandCollege ParkMarylandUSA
- Department of Veterans Affairs and Veterans Affairs Medical Center, Geriatric ResearchEducation and Clinical CenterBaltimoreMarylandUSA
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Natanzon SS, Han D, Kuronuma K, Gransar H, Miller RJH, Slomka PJ, Dey D, Hayes SW, Friedman JD, Thomson LEJ, Berman DS, Rozanski A. Self-reported exercise activity influences the relationship between coronary computed tomography angiographic finding and mortality. J Cardiovasc Comput Tomogr 2024; 18:327-333. [PMID: 38589269 DOI: 10.1016/j.jcct.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/04/2024] [Accepted: 03/22/2024] [Indexed: 04/10/2024]
Abstract
AIM Recent studies suggest that the application of exercise activity questionnaires, including the use of a single-item exercise question, can be additive to the prognostic efficacy of imaging findings. This study aims to evaluate the prognostic efficacy of exercise activity in patients undergoing coronary computed tomography angiography (CCTA). METHODS AND RESULTS We assessed 9772 patients who underwent CCTA at a single center between 2007 and 2020. Patients were divided into 4 groups of physical activity as no exercise (n = 1643, 17%), mild exercise (n = 3156, 32%), moderate exercise (n = 3542, 36%), and high exercise (n = 1431,15%), based on a single-item self-reported questionnaire. Coronary stenosis was categorized as no (0%), non-obstructive (1-49%), borderline (50-69%), and obstructive (≥70%). During a median follow-up of 4.64 (IQR 1.53-7.89) years, 490 (7.6%) died. There was a stepwise inverse relationship between exercise activity and mortality (p < 0.001). Compared with the high activity group, the no activity group had a 3-fold higher mortality risk (HR: 3.3, 95%CI (1.94-5.63), p < 0.001) after adjustment for age, clinical risk factors, symptoms, and statin use. For any level of CCTA stenosis, mortality rates were inversely associated with the degree of patients' exercise activity. The risk of all-cause mortality was similar among the patients with obstructive stenosis with high exercise versus those with no coronary stenosis but no exercise activity (p = 0.912). CONCLUSION Physical activity as assessed by a single-item self-reported questionnaire is a strong stepwise inverse predictor of mortality risk among patients undergoing CCTA.
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Affiliation(s)
- Sharon Shalom Natanzon
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Donghee Han
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Keiichiro Kuronuma
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Heidi Gransar
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Robert J H Miller
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Piotr J Slomka
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Damini Dey
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sean W Hayes
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - John D Friedman
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Louise E J Thomson
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alan Rozanski
- Division of Cardiac Sciences, Mount Sinai Morningside Hospital, Mount Sinai Heart and the Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Gower B, Blacket C, Girard D, Boyle T, Davison K. Prospective associations between systolic blood pressure, serum cholesterol, and physical activity behaviour and the development of cardiovascular disease. Prev Med 2024; 183:107958. [PMID: 38657686 DOI: 10.1016/j.ypmed.2024.107958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/22/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
AIMS To systematically appraise and summarise meta-analyses of longitudinal studies to determine the effect size, and quality and certainty of the evidence summaries for systolic blood pressure (SBP), serum cholesterol, and physical activity behaviour in developing cardiovascular disease (CVD). METHODS AND RESULTS An umbrella review was conducted by searching MEDLINE, Embase, and Scopus databases. Eligible meta-analyses were longitudinal studies investigating the association between SBP, serum cholesterol, or physical activity behaviour on CVD development. Summary risk estimates were extracted. Quality and certainty of the evidence summaries of included records were performed using AMSTAR 2 and GRADE, respectively. Forty-one eligible records were found of which thirteen related to SBP, five to cholesterol, and twenty-three to physical activity behaviour. The quality and certainty of the evidence summaries were variable, with most studies rating 'low'. Reported risk estimates for the risk of developing CVD ranged from: no change to a 68% decreased risk for lower SBP; a 21% increased risk to a 44% decreased risk for lower cholesterol; and a 1% decreased risk to a 56% decreased risk for higher physical activity levels. CONCLUSIONS There were strong associations with CVD risk at the meta-analysis level for all three exposures, with a proportionally greater number of meta-analyses and primary studies for physical activity than SBP or serum cholesterol. Given the number of meta-analyses and similar CVD risk reductions and certainty of evidence associated with physical activity behaviour, there is a strong case for its routine assessment alongside SBP and serum cholesterol in primary CVD prevention.
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Affiliation(s)
- Bethany Gower
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia.
| | - Chloe Blacket
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
| | - Danielle Girard
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
| | - Terry Boyle
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; University of South Australia, Australian Centre for Precision Health, Adelaide, Australia
| | - Kade Davison
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
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Mentias A, Keshvani N, Sumarsono A, Desai R, Khan MS, Menon V, Hsich E, Bress AP, Jacobs J, Vasan RS, Fonarow GC, Pandey A. Patterns, Prognostic Implications, and Rural-Urban Disparities in Optimal GDMT Following HFrEF Diagnosis Among Medicare Beneficiaries. JACC. HEART FAILURE 2024; 12:1044-1055. [PMID: 37943222 DOI: 10.1016/j.jchf.2023.08.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Patterns and disparities in guideline-directed medical therapy (GDMT) uptake for heart failure with reduced ejection fraction (HFrEF) across rural vs urban regions are not well described. OBJECTIVES This study aims to evaluate patterns, prognostic implications, and rural-urban differences in GDMT use among Medicare beneficiaries following new-onset HFrEF. METHODS Patients with a diagnosis of new-onset HFrEF in a 5% Medicare sample with available data for Part D medication use were identified from January 2015 through December 2020. The primary exposure was residence in rural vs urban zip codes. Optimal triple GDMT was defined as ≥50% of the target daily dose of beta-blockers, ≥50% of the target daily dose of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker or any dose of sacubitril/valsartan, and any dose of mineralocorticoid receptor antagonist. The association between the achievement of optimal GDMT over time following new-onset HFrEF diagnosis and risk of all-cause mortality and subsequent HF hospitalization was also evaluated using adjusted Cox models. The association between living in rural vs urban location and time to optimal GDMT achievement over a 12-month follow-up was assessed using cumulative incidence curves and adjusted Fine-Gray subdistribution hazard models. RESULTS A total of 41,296 patients (age: 76.7 years; 15.0% Black; 27.6% rural) were included. Optimal GDMT use over the 12-month follow-up was low, with 22.5% initiated on any dose of triple GDMT and 9.1% on optimal GDMT doses. Optimal GDMT on follow-up was significantly associated with a lower risk of death (HR: 0.89 [95% CI: 0.85-0.94]; P < 0.001) and subsequent HF hospitalization (HR: 0.93 [95% CI: 0.87-0.98]; P = 0.02). Optimal GDMT use at 12 months was significantly lower among patients living in rural (vs urban) areas (8.4% vs 9.3%; P = 0.02). In adjusted analysis, living in rural (vs urban) locations was associated with a significantly lower probability of achieving optimal GDMT (HR: 0.92 [95% CI: 0.86-0.98]; P = 0.01 Differences in optimal GDMT use following HFrEF diagnosis accounted for 16% of excess mortality risk among patients living in rural (vs urban) areas. CONCLUSIONS Use of optimal GDMT following new-onset HFrEF diagnosis is low, with substantially lower use noted among patients living in rural vs urban locations. Suboptimal GDMT use following new-onset HFrEF was associated with an increased risk of mortality and subsequent HF hospitalization.
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Affiliation(s)
- Amgad Mentias
- Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Neil Keshvani
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Andrew Sumarsono
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | - Venu Menon
- Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Eileen Hsich
- Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Adam P Bress
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Joshua Jacobs
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Ramachandran S Vasan
- School of Public Health, Department of Population Health, and Division of Cardiology, Long School of Medicine, University of Texas San Antonio, San Antonio, Texas, USA
| | - Gregg C Fonarow
- Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Los Angeles, California, USA
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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Ge G, Bo D, Zhang F, Yang D. Non-Linear Association between Obstructive Sleep Apnea Risk and Lipid Profile: Data from the 2015-2018 National Health and Nutrition Examination Survey. Rev Cardiovasc Med 2024; 25:175. [PMID: 39076499 PMCID: PMC11267181 DOI: 10.31083/j.rcm2505175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 07/31/2024] Open
Abstract
Background The relationship between the multivariable apnea prediction (MAP) index and lipid levels was examined using a cross-sectional and retrospective study of National Health and Nutrition Examination Surveys (2015-2018). A total of 3195 participants with MAP scores were included in the analysis. Methods The MAP index, an algorithm leveraging sleep apnea symptom frequency, body mass index (BMI), age, and sex, estimates the risk of obstructive sleep apnea (OSA). We investigated the associations between the MAP index and lipid profiles-specifically, high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) -using weighted linear regression and restricted cubic splines (RCS) analysis. Additionally, mediation analysis was conducted to explore the potential mediating role of physical activity on the link between OSA risk, hyperlipidemia, and cardiovascular mortality. Results A non-linear relationship was observed between OSA severity and lipid profiles, including elevated levels of TC, increased LDL-C, higher TG, and decreased HDL-C (All p for non-linearity < 0.05). The findings remained consistent across the stratified sensitivity analyses. Furthermore, physical activity served as a mediator in the association between the MAP index and both hyperlipidemia and cardiovascular mortality, accounting for 16.6% and 16.7% of the indirect effects, respectively. Conclusions Participants at high risk for OSA demonstrated an increased prevalence of dyslipidemia. Additionally, engagement in physical activity was shown to have beneficial effects on lipid metabolism.
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Affiliation(s)
- Gaoyuan Ge
- Department of Cardiology, The First Affiliated Hospital
of Nanjing Medical University, 210029 Nanjing, Jiangsu, China
- Department of Cardiology, The Affiliated Hospital of Yangzhou University,
225000 Yangzhou, Jiangsu, China
| | - Dan Bo
- Department of Cardiology, The First Affiliated Hospital
of Nanjing Medical University, 210029 Nanjing, Jiangsu, China
| | - Fengxiang Zhang
- Department of Cardiology, The First Affiliated Hospital
of Nanjing Medical University, 210029 Nanjing, Jiangsu, China
| | - Di Yang
- Department of Cardiology, The First Affiliated Hospital
of Nanjing Medical University, 210029 Nanjing, Jiangsu, China
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40
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Lear R, Metcalf B, Hillsdon M, Bond B, Koster A, Vandercappellen E, de Galan B, Berendschot TTJM, Houben A, Kooman J, Kroon AA, Bosma H, Eussen SJPM, Pulsford R. Associations of between- and within-day patterns of physical activity accumulation with arterial stiffness and indices of microvascular health-Evidence from The Maastricht study. Scand J Med Sci Sports 2024; 34:e14649. [PMID: 38757450 DOI: 10.1111/sms.14649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024]
Abstract
While physical activity (PA) is understood to promote vascular health, little is known about whether the daily and weekly patterns of PA accumulation associate with vascular health. Accelerometer-derived (activPAL3) 6- or 7-day stepping was analyzed for 6430 participants in The Maastricht Study (50.4% women; 22.4% Type 2 diabetes mellitus (T2DM)). Multivariable regression models examined associations between stepping metrics (average step count, and time spent slower and faster paced stepping) with arterial stiffness (measured as carotid-femoral pulse wave velocity (cfPWV)), and several indices of microvascular health (heat-induced skin hyperemia, retinal vessel reactivity and diameter), adjusting for confounders and moderators. PA pattern metrics were added to the regression models to identify associations with vascular health beyond that of stepping metrics. Analyses were stratified by T2DM status if an interaction effect was present. Average step count and time spent faster paced stepping was associated with better vascular health, and the association was stronger in those with compared to those without T2DM. In fully adjusted models a higher step count inter-daily stability was associated with a higher (worse) cfPWV in those without T2DM (std β = 0.04, p = 0.007) and retinal venular diameter in the whole cohort (std β = 0.07, p = 0.002). A higher within-day variability in faster paced stepping was associated with a lower (worse) heat-induced skin hyperemia in those with T2DM (std β = -0.31, p = 0.008). Above and beyond PA volume, the daily and weekly patterns in which PA was accumulated were additionally associated with improved macro- and microvascular health, which may have implications for the prevention of vascular disease.
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Affiliation(s)
- Rebecca Lear
- Department of Public Health and Sports Sciences, University of Exeter, Exeter, Devon, UK
| | - Brad Metcalf
- Department of Public Health and Sports Sciences, University of Exeter, Exeter, Devon, UK
| | - Melvyn Hillsdon
- Department of Public Health and Sports Sciences, University of Exeter, Exeter, Devon, UK
| | - Bert Bond
- Children's Health and Exercise Research Centre, Department of Public Health and Sports Sciences, University of Exeter, Exeter, Devon, UK
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Evelien Vandercappellen
- Department of Internal Medicine and Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bastiaan de Galan
- Department of Internal Medicine and School for Cardiovascular Diseases CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Alfons Houben
- Department of Internal Medicine and School for Cardiovascular Diseases CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jeroen Kooman
- Department of Internal Medicine, Division of Nephrology, NUTRIM Research Institute, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine and School for Cardiovascular Diseases CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, and CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Richard Pulsford
- Department of Public Health and Sports Sciences, University of Exeter, Exeter, Devon, UK
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Ahmad S, Moorthy MV, Lee IM, Ridker PM, Manson JE, Buring JE, Demler OV, Mora S. Mediterranean Diet Adherence and Risk of All-Cause Mortality in Women. JAMA Netw Open 2024; 7:e2414322. [PMID: 38819819 PMCID: PMC11143458 DOI: 10.1001/jamanetworkopen.2024.14322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/01/2024] [Indexed: 06/01/2024] Open
Abstract
Importance Higher adherence to the Mediterranean diet has been associated with reduced risk of all-cause mortality, but data on underlying molecular mechanisms over long follow-up are limited. Objectives To investigate Mediterranean diet adherence and risk of all-cause mortality and to examine the relative contribution of cardiometabolic factors to this risk reduction. Design, Setting, and Participants This cohort study included initially healthy women from the Women's Health Study, who had provided blood samples, biomarker measurements, and dietary information. Baseline data included self-reported demographics and a validated food-frequency questionnaire. The data collection period was from April 1993 to January 1996, and data analysis took place from June 2018 to November 2023. Exposures Mediterranean diet score (range, 0-9) was computed based on 9 dietary components. Main Outcome and Measures Thirty-three blood biomarkers, including traditional and novel lipid, lipoprotein, apolipoprotein, inflammation, insulin resistance, and metabolism measurements, were evaluated at baseline using standard assays and nuclear magnetic resonance spectroscopy. Mortality and cause of death were determined from medical and death records. Cox proportional hazards regression was used to calculate hazard ratios (HRs) for Mediterranean diet adherence and mortality risk, and mediation analyses were used to calculate the mediated effect of different biomarkers in understanding this association. Results Among 25 315 participants, the mean (SD) baseline age was 54.6 (7.1) years, with 329 (1.3%) Asian women, 406 (1.6%) Black women, 240 (0.9%) Hispanic women, 24 036 (94.9%) White women, and 95 (0.4%) women with other race and ethnicity; the median (IQR) Mediterranean diet adherence score was 4.0 (3.0-5.0). Over a mean (SD) of 24.7 (4.8) years of follow-up, 3879 deaths occurred. Compared with low Mediterranean diet adherence (score 0-3), adjusted risk reductions were observed for middle (score 4-5) and upper (score 6-9) groups, with HRs of 0.84 (95% CI, 0.78-0.90) and 0.77 (95% CI, 0.70-0.84), respectively (P for trend < .001). Further adjusting for lifestyle factors attenuated the risk reductions, but they remained statistically significant (middle adherence group: HR, 0.92 [95% CI, 0.85-0.99]; upper adherence group: HR, 0.89 [95% CI, 0.82-0.98]; P for trend = .001). Of the biomarkers examined, small molecule metabolites and inflammatory biomarkers contributed most to the lower mortality risk (explaining 14.8% and 13.0%, respectively, of the association), followed by triglyceride-rich lipoproteins (10.2%), body mass index (10.2%), and insulin resistance (7.4%). Other pathways, including branched-chain amino acids, high-density lipoproteins, low-density lipoproteins, glycemic measures, and hypertension, had smaller contributions (<3%). Conclusions and Relevance In this cohort study, higher adherence to the Mediterranean diet was associated with 23% lower risk of all-cause mortality. This inverse association was partially explained by multiple cardiometabolic factors.
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Affiliation(s)
- Shafqat Ahmad
- Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Sweden
| | - M. Vinayaga Moorthy
- Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Julie E. Buring
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Olga V. Demler
- Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Computer Science, ETH Zurich, Zürich, Switzerland
| | - Samia Mora
- Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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42
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Zureigat H, Osborne MT, Abohashem S, Mezue K, Gharios C, Grewal S, Cardeiro A, Naddaf N, Civieri G, Abbasi T, Radfar A, Aldosoky W, Seligowski AV, Wasfy MM, Guseh JS, Churchill TW, Rosovsky RP, Fayad Z, Rosenzweig A, Baggish A, Pitman RK, Choi KW, Smoller J, Shin LM, Tawakol A. Effect of Stress-Related Neural Pathways on the Cardiovascular Benefit of Physical Activity. J Am Coll Cardiol 2024; 83:1543-1553. [PMID: 38631773 PMCID: PMC11164527 DOI: 10.1016/j.jacc.2024.02.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/25/2024] [Accepted: 02/15/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The mechanisms underlying the psychological and cardiovascular disease (CVD) benefits of physical activity (PA) are not fully understood. OBJECTIVES This study tested whether PA: 1) attenuates stress-related neural activity, which is known to potentiate CVD and for its role in anxiety/depression; 2) decreases CVD in part through this neural effect; and 3) has a greater impact on CVD risk among individuals with depression. METHODS Participants from the Mass General Brigham Biobank who completed a PA survey were studied. A subset underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomographic imaging. Stress-related neural activity was measured as the ratio of resting amygdalar-to-cortical activity (AmygAC). CVD events were ascertained from electronic health records. RESULTS A total of 50,359 adults were included (median age 60 years [Q1-Q3: 45-70 years]; 40.1% male). Greater PA was associated with both lower AmygAC (standardized β: -0.245; 95% CI: -0.444 to -0.046; P = 0.016) and CVD events (HR: 0.802; 95% CI: 0.719-0.896; P < 0.001) in multivariable models. AmygAC reductions partially mediated PA's CVD benefit (OR: 0.96; 95% CI: 0.92-0.99; P < 0.05). Moreover, PA's benefit on incident CVD events was greater among those with (vs without) preexisting depression (HR: 0.860; 95% CI: 0.810-0.915; vs HR: 0.929; 95% CI: 0.910-0.949; P interaction = 0.011). Additionally, PA above guideline recommendations further reduced CVD events, but only among those with preexisting depression (P interaction = 0.023). CONCLUSIONS PA appears to reduce CVD risk in part by acting through the brain's stress-related activity; this may explain the novel observation that PA reduces CVD risk to a greater extent among individuals with depression.
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Affiliation(s)
- Hadil Zureigat
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Michael T Osborne
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shady Abohashem
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kenechukwu Mezue
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Charbel Gharios
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Simran Grewal
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Alex Cardeiro
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Nicki Naddaf
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Giovanni Civieri
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Taimur Abbasi
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Azar Radfar
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Wesam Aldosoky
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Antonia V Seligowski
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts, USA, and Harvard Medical School, Boston, Massachusetts, USA
| | - Meagan M Wasfy
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - James Sawalla Guseh
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy W Churchill
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel P Rosovsky
- Division of Hematology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Zahi Fayad
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anthony Rosenzweig
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Aaron Baggish
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Roger K Pitman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jordan Smoller
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lisa M Shin
- Department of Psychology, Tufts University, Medford, Massachusetts, USA
| | - Ahmed Tawakol
- Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
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43
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Luo P, Wu R, Gao W, Yan W, Wang R, Ye Y. Effects of high-intensity interval exercise on arterial stiffness in individuals at risk for cardiovascular disease: a meta-analysis. Front Cardiovasc Med 2024; 11:1376861. [PMID: 38694567 PMCID: PMC11061535 DOI: 10.3389/fcvm.2024.1376861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/04/2024] [Indexed: 05/04/2024] Open
Abstract
Objective The purpose of this meta-analysis was to investigate the effect of high-intensity interval training (HIIT) on arterial stiffness (AS) and vascular function in persons at high risk of cardiovascular disease (CVD). Methods We conducted a comprehensive search of randomized controlled trials (RCTs) published in electronic databases (PubMed, Web of Science, Cochrane, Embase, and Ebsco) since their inception through October 2023 to evaluate the effect of HIIT on AS and vascular function in persons at high risk for CVD. The weighted mean difference (WMD) and 95% confidence intervals (95% CI) were calculated, and heterogeneity was assessed using the I2 test. Results This study included 661 participants from 16 studies. HIIT significantly reduced pulse wave velocity (PWV) in persons at high risk for CVD [weighted mean difference (WMD), -0.62; 95% CI, -0.86--0.38; P < 0.00001]. Subgroup analysis showed that the PWV improvement effect was better when the HIIT program was performed 2-3 times per week and the duration was controlled within 40 min [2-3 times, -0.67; 95% CI, -0.93--0.41; P < 0.00001; time of duration, ≤40 min, -0.66; 95% CI, -0.91--0.41; P < 0.00001]. HIIT significantly reduced systolic blood pressure (SBP, -5.43; 95% CI, -8.82--2.04; P = 0.002), diastolic blood pressure (DPB, -2.96; 95% CI, -4.88--1.04; P = 0.002), and resting heart rate (RHR, -4.35; 95% CI, -7.04--1.66; P = 0.002), but had no significant effect on augmentation index (AIX, -2.14; 95% CI, -6.77-2.50; P = 0.37). Conclusion HIIT can improve PWV in high-risk individuals with CVD and reduce SBP, DBP, and RHR, but has no significant effect on AIX. HIIT can effectively improve AS and vascular function and can be recommended as an effective method to improve AS in high-risk persons with CVD. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42023471593.
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Affiliation(s)
- Ping Luo
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Ruoshan Wu
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Weifeng Gao
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Weiyi Yan
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Ruixue Wang
- School of Physical Education, Wuhan Sport University, Wuhan, China
| | - Yufang Ye
- School of Physical Education, Wuhan Sport University, Wuhan, China
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Moore AZ, Simonsick EM, Landman B, Schrack J, Wanigatunga AA, Ferrucci L. Correlates of life course physical activity in participants of the Baltimore longitudinal study of aging. Aging Cell 2024; 23:e14078. [PMID: 38226778 PMCID: PMC11019133 DOI: 10.1111/acel.14078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024] Open
Abstract
Physical activity is consistently associated with better health and longer life spans. However, the extent to which length and intensity of exercise across the life course impact health outcomes relative to current activity is undefined. Participants of the Baltimore Longitudinal Study of Aging were asked to categorize their level of physical activity in each decade of life from adolescence to the current decade. In linear mixed effects models, self-reported past levels of physical activity were significantly associated with activity assessed at study visits in the corresponding decade of life either by questionnaire or accelerometry. A pattern of life course physical activity (LCPA) derived by ranking participants on reported activity intensity across multiple decades was consistent with the trajectories of activity estimated from standard physical activity questionnaires assessed at prior study visits. In multivariable linear regression models LCPA was associated with clinical characteristics, measures of body composition and indicators of physical performance independent of current physical activity. After adjustment for minutes of high intensity exercise, LCPA remained significantly associated with peak VO2, fasting glucose, thigh muscle area and density, abdominal subcutaneous fat, usual gait speed, lower extremity performance, and multimorbidity (all p < 0.01) at the index visit. The observed associations suggest that an estimate of physical activity across decades provides complementary information to information on current activity and reemphasizes the importance of consistently engaging in physical activity over the life course.
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Affiliation(s)
- Ann Zenobia Moore
- Translational Gerontology Branch, Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
| | - Eleanor M. Simonsick
- Translational Gerontology Branch, Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
| | - Bennett Landman
- Department of Electrical and Computer EngineeringVanderbilt UniversityNashvilleTennesseeUSA
| | - Jennifer Schrack
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Amal A. Wanigatunga
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Luigi Ferrucci
- Translational Gerontology Branch, Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
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45
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Salmio A, Rissanen APE, Kurkela JLO, Rottensteiner M, Seipäjärvi S, Juurakko J, Kujala UM, Laukkanen JA, Wikgren J. Cardiorespiratory fitness is linked with heart rate variability during stress in "at-risk" adults. J Sports Med Phys Fitness 2024; 64:334-347. [PMID: 38213267 DOI: 10.23736/s0022-4707.23.15373-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Physiological mechanisms explaining why cardiorespiratory fitness (CRF) predicts cardiovascular morbidity and mortality are incompletely understood. We examined if CRF modifies vagally mediated heart rate variability (HRV) during acute physical or psychosocial stress or night-time sleep in adults with cardiovascular risk factors. METHODS Seventy-eight adults (age 56 years [IQR 50-60], 74% female, body mass index 28 kg/m2 [IQR 25-31]) with frequent cardiovascular risk factors participated in this cross-sectional study. They went through physical (treadmill cardiopulmonary exercise test [CPET]) and psychosocial (Trier Social Stress Test for Groups [TSST-G]) stress tests and night-time sleep monitoring (polysomnography). Heart rate (HR) and vagally mediated HRV (root mean square of successive differences between normal R-R intervals [RMSSD]) were recorded during the experiments and analyzed by taking account of potential confounders. RESULTS CRF (peak O2 uptake) averaged 99% (range 78-126) in relation to reference data. From pre-rest to moderate intensities during CPET and throughout TSST-G, HR did not differ between participants with CRF below median (CRFlower) and CRF equal to or above median (CRFhigher), whereas CRFhigher had higher HRV than CRFlower, and CRF correlated positively with HRV in all participants. Meanwhile, CRF had no independent associations with HR or HRV levels during slow-wave sleep, the presence of metabolic syndrome was not associated with recorded HR or HRV levels, and single factors predicted HRV responsiveness independently only to limited extents. CONCLUSIONS CRF is positively associated with prevailing vagally mediated HRV at everyday levels of physical and psychosocial stress in adults with cardiovascular risk factors.
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Affiliation(s)
- Anniina Salmio
- Center for Interdisciplinary Brain Research, Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Antti-Pekka E Rissanen
- Central Finland Health Care District, Jyväskylä, Finland -
- Sports and Exercise Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- HULA - Helsinki Sports and Exercise Medicine Clinic, Foundation for Sports and Exercise Medicine, Helsinki, Finland
| | - Jari L O Kurkela
- Center for Interdisciplinary Brain Research, Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Mirva Rottensteiner
- Central Finland Health Care District, Jyväskylä, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Santtu Seipäjärvi
- Center for Interdisciplinary Brain Research, Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Joona Juurakko
- Center for Interdisciplinary Brain Research, Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari A Laukkanen
- Central Finland Health Care District, Jyväskylä, Finland
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jan Wikgren
- Center for Interdisciplinary Brain Research, Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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Lu CY, Li-Sheng Chen S, Pan SL. Physical activity and the risk of ischemic stroke: A population-based longitudinal follow-up study in Taiwan (KCIS no. 43). J Clin Neurosci 2024; 121:18-22. [PMID: 38325056 DOI: 10.1016/j.jocn.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/03/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
Lack of exercise is a leading risk factor for stroke, and it has been demonstrated that increasing physical activity (PA) can prevent ischemic stroke. However, there has been limited research on the relationship between ischemic stroke and PA, especially among Asian populations. This study therefore investigates whether the level of PA in the Taiwanese population affects its risk of first-ever ischemic stroke, utilizing screening data on 58,857 individuals collected by the Keelung Health Bureau between 2005 and 2012. These subjects were divided into three groups based on their weekly exercise frequency and duration, i.e., 1) a no PA (NPA) group, 2) a low PA (LPA) group (less than 90 min of exercise per week), and 3) a high PA (HPA) group (90 min or more of exercise per week). The results showed that, as compared to the NPA group, the adjusted hazard ratio for ischemic stroke in the LPA group was 0.86 (95 % CI, 0.78-0.95, p < 0.0001); and that in the HPA group, it was also 0.86 (95 % CI, 0.79-0.94, p < 0.0001). In other words, even engaging in PA for less than 90 min per week may lower the risk of first-ever ischemic stroke. Importantly, LPA is more accessible, more sustainable, and easier to promote for the general population than the 150 min per week recommended by the World Health Organization.
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Affiliation(s)
- Ching-Yu Lu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shin-Liang Pan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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47
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Ghosal AM, Chandrasekaran B. Stair-climbing interventions on cardio-metabolic outcomes in adults: A scoping review. J Taibah Univ Med Sci 2024; 19:136-150. [PMID: 38021217 PMCID: PMC10656261 DOI: 10.1016/j.jtumed.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/30/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Physical inactivity is linked with high chronic disease risk; however, only a fraction of the global population meets the recommendations for physical activity. Stair-climbing is a simple and accessible form of physical activity that has been shown to improve cardio-metabolic outcomes in adults. The present scoping review explores the physiological and therapeutic effects of stair-climbing interventions on adult cardio-metabolic disease risk factors. Methods This scoping review followed the reporting guidelines of the Arksey & O'Malley framework, which collates evidence in stages. The research question was framed as "What are the effects of stair climbing on cardio-metabolic outcomes in adults?". Eligible articles were identified through an extensive search of four electronic databases, and data from 24 research studies were charted and organized. Results Stair climbing improves aerobic capacity (8-33 ml kg/min) and serum biomarkers by ≈9-15 %. A minimum of 4-8 weeks are necessary to alter cardiometabolic risk. Regular stair climbing can improve cardio-metabolic risk indicators, including body composition, blood pressure, cholesterol levels, and insulin sensitivity. The research regarding inflammatory and musculoskeletal changes with stair climbing bouts is still in its infancy. Conclusion Stair climbing interventions are a no-cost and feasible form of physical activity for improving cardiometabolic disease risk in adults.
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Affiliation(s)
- Anang M. Ghosal
- Department of Exercise and Sport Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Baskaran Chandrasekaran
- Department of Exercise and Sport Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Henson J, Yates T, Bhattacharjee A, Chudasama YV, Davies MJ, Dempsey PC, Goldney J, Khunti K, Laukkanen JA, Razieh C, Rowlands AV, Zaccardi F. Walking pace and the time between the onset of noncommunicable diseases and mortality: a UK Biobank prospective cohort study. Ann Epidemiol 2024; 90:21-27. [PMID: 37820945 DOI: 10.1016/j.annepidem.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE To estimate time spent in various cardiovascular disease (CVD) and cancer states, according to self-reported walking pace. METHODS In total, 391,744 UK Biobank participants were included (median age = 57 years; 54.7% women). Data were collected 2006-2010, with follow-up collected in 2021. Usual walking pace was self-defined as slow, steady, average, or brisk. Multistate modeling determined the transition rate and mean sojourn time in and across three different states (healthy, CVD or cancer, and death) upon a time horizon of 10 years. RESULTS The mean sojourn time in the healthy state was longer, while that in the CVD or cancer state was shorter in individuals reporting an average or brisk walking pace (vs. slow). A 75-year-old woman reporting a brisk walking pace spent, on average, 8.4 years of the next 10 years in a healthy state; an additional 8.0 (95% CI: 7.3, 8.7) months longer than a 75-year-old woman reporting a slow walking pace. This corresponded to 4.3 (3.7, 4.9) fewer months living with CVD or cancer. Similar results were seen in men. CONCLUSIONS Adults reporting an average or brisk walking pace at baseline displayed a lower transition to disease development and a greater proportion of life lived without CVD or cancer. AVAILABILITY OF DATA AND MATERIALS Research was conducted using the UK Biobank resource under Application #33266. The UK Biobank resource can be accessed by researchers on application. Variables derived for this study have been returned to the UK Biobank for future applicants to request. No additional data are available.
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Affiliation(s)
- Joseph Henson
- NIHR Leicester Biomedical Research Centre (Lifestyle), Leicester, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK.
| | - Thomas Yates
- NIHR Leicester Biomedical Research Centre (Lifestyle), Leicester, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Atanu Bhattacharjee
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Leicester Real World Evidence Unit, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Yogini V Chudasama
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Leicester Real World Evidence Unit, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Melanie J Davies
- NIHR Leicester Biomedical Research Centre (Lifestyle), Leicester, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Paddy C Dempsey
- NIHR Leicester Biomedical Research Centre (Lifestyle), Leicester, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Jonathan Goldney
- NIHR Leicester Biomedical Research Centre (Lifestyle), Leicester, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; NIHR Applied Health Research Collaboration-East Midlands (NIHR ARC-EM), Leicester Diabetes Centre, Leicester, UK
| | - Jari A Laukkanen
- Institute of Clinical Medicine and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Cameron Razieh
- NIHR Leicester Biomedical Research Centre (Lifestyle), Leicester, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Leicester Real World Evidence Unit, University of Leicester, Leicester General Hospital, Leicester, UK; Office for National Statistics, Data & Analysis for Social Care and Health (DASCH) Division, Newport, UK
| | - Alex V Rowlands
- NIHR Leicester Biomedical Research Centre (Lifestyle), Leicester, UK; Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Francesco Zaccardi
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK; Leicester Real World Evidence Unit, University of Leicester, Leicester General Hospital, Leicester, UK
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49
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Moreau KL, Clayton ZS, DuBose LE, Rosenberry R, Seals DR. Effects of regular exercise on vascular function with aging: Does sex matter? Am J Physiol Heart Circ Physiol 2024; 326:H123-H137. [PMID: 37921669 PMCID: PMC11208002 DOI: 10.1152/ajpheart.00392.2023] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Vascular aging, featuring endothelial dysfunction and large elastic artery stiffening, is a major risk factor for the development of age-associated cardiovascular diseases (CVDs). Vascular aging is largely mediated by an excessive production of reactive oxygen species (ROS) and increased inflammation leading to reduced bioavailability of the vasodilatory molecule nitric oxide and remodeling of the arterial wall. Other cellular mechanisms (i.e., mitochondrial dysfunction, impaired stress response, deregulated nutrient sensing, cellular senescence), termed "hallmarks" or "pillars" of aging, may also contribute to vascular aging. Gonadal aging, which largely impacts women but also impacts some men, modulates the vascular aging process. Regular physical activity, including both aerobic and resistance exercise, is a first-line strategy for reducing CVD risk with aging. Although exercise is an effective intervention to counter vascular aging, there is considerable variation in the vascular response to exercise training with aging. Aerobic exercise improves large elastic artery stiffening in both middle-aged/older men and women and enhances endothelial function in middle-aged/older men by reducing oxidative stress and inflammation and preserving nitric oxide bioavailability; however, similar aerobic exercise training improvements are not consistently observed in estrogen-deficient postmenopausal women. Sex differences in adaptations to exercise may be related to gonadal aging and declines in estrogen in women that influence cellular-molecular mechanisms, disconnecting favorable signaling in the vasculature induced by exercise training. The present review will summarize the current state of knowledge on vascular adaptations to regular aerobic and resistance exercise with aging, the underlying mechanisms involved, and the moderating role of biological sex.
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Affiliation(s)
- Kerrie L Moreau
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, Colorado, United States
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Lyndsey E DuBose
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Ryan Rosenberry
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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Nierwińska K, Myśliwiec A, Konarska-Rawluk A, Lipowicz A, Małecki A, Knapik A. SMART System in the Assessment of Exercise Tolerance in Adults. SENSORS (BASEL, SWITZERLAND) 2023; 23:9624. [PMID: 38139470 PMCID: PMC10747569 DOI: 10.3390/s23249624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
Health-oriented physical activity should meet two key criteria: safety and an optimal level of exercise. The system of monitoring and rationalization of training (SMART) was designed to meet them. SMART integrates a custom-configured inertial measurement unit (IMU) and a sensor with real-time heart rate measurement (HR) using a proprietary computer application. SMART was used to evaluate the safety and exercise load with 115 study participants: 51 women (44.35%) and 64 men (55.65%) aged 19 to 65 years. The exercise test was the 6MWT test. In 35% of the participants, the mean HR exceeded the recognized safe limit of HR 75% max. Ongoing monitoring of HR allows for optimal exercise and its safety. Step count data were collected from the SMART system. The average step length was calculated by dividing the distance by the number of steps. The aim of the present study was to assess the risk of excessive cardiovascular stress during the 6MWT test using the SMART system.
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Affiliation(s)
- Katarzyna Nierwińska
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Andrzej Myśliwiec
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Anna Konarska-Rawluk
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Anna Lipowicz
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
- Department of Antropology, Wrocław University of Environmental and Life Sciences, 50-375 Wrocław, Poland
| | - Andrzej Małecki
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Andrzej Knapik
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
- Department of Adapted Physical Activity and Sport, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
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