Abstract
Background: Age is a key determinant for the development of cardiovascular disease and higher age coincides with an increased prevalence of obesity and physical inactivity. The study examines the influence of physical activity on aging processes of physiological systems focusing on the mechanisms of vascular aging.Methods/Design: The study consists of two parts. The cross-sectional approach aims at examining the association of physical fitness and cardiovascular risk with large and small artery function in healthy older active (HOA, n = 40) and sedentary (HOS, n = 40) persons as well as older sedentary individuals with increased cardiovascular risk (OSR, n = 80) aged 50–80 years. In the interventional approach, the OSR group is randomized into a 12-week walking-based high intensity interval training (HIIT) group or a control condition, aiming at examining the effects of HIIT on arterial function in diseased older adults. Active lifestyle is defined as >9 metabolic equivalent of task (MET) per week and sedentary as ≤3 MET/week. Inclusion criteria for OSR are overweight or obesity (body mass index ≥30 kg/m2) plus at least one additional cardiovascular risk factor. The primary outcome is arterial stiffness as determined by aortic pulse wave velocity (PWV). The secondary outcomes are retinal arterial and venous diameters. Further cardiovascular assessments include peripheral PWV, central haemodynamics, retinal endothelial function, carotid intima media thickness, cardiac strain and diastolic function as well as autonomic function and inflammation. Physical fitness is measured by a treadmill-based spiroergometry to determine peak oxygen uptake.Discussion: The aim of the study is to demonstrate the importance of and need for specific physical activity programs for seniors to achieve healthier aging as a long-term goal. Vascular function defines disease- and age-related end organ damage and represents the potential to contain health at older age. This research will identify cardiovascular biomarkers that best resemble underlying cardiovascular risk in age and disease. The integrated approach will help define new recommendations for treatment guidance of exercise therapy in an aging population.ClinicalTrials. gov: NCT02796976; registered 02 June 2016 (retrospectively registered).
Highlights
Age is a key determinant for the development of cardiovascular disease and higher age coincides with an increased prevalence of obesity and physical inactivity
We have previously shown that higher physical fitness levels are associated with higher retinal arteriolar-to-venular diameter ratio (AVR) and that regular endurance exercise induced arteriolar dilatation as well as venular constriction, leading to a significantly improved AVR in middle-aged lean and obese individuals (Hanssen et al, 2011)
The cross-sectional approach enables to investigate the association of physical activity with the process of normal, healthy aging comparing the healthy older active (HOA) group with healthy older sedentary (HOS)
Summary
Age is a key determinant for the development of cardiovascular disease and higher age coincides with an increased prevalence of obesity and physical inactivity. Atherosclerotic cardiovascular disease (CVD) is a chronic inflammatory disease of the circulatory system and it is a main health care threat in western countries. Almost every third death can be attributed to CVD, amounting to a total of 17.5 million associated deaths worldwide (World Health Organization, 2014). Age is one of the major risk factors for the development of CVD and demographic change further aggravates the enormous socio-economic health care challenge. The number of persons aged 60 or older will double until the year 2050, which will further aggravate the burden of age-related diseases such as CVD (World Population Prospects, 2015). Aging is associated with complex structural and functional alterations of the vascular bed (Ferrari et al, 2003)
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