Abstract
IntroductionCardiovascular aging is implicated in the development of cardiovascular disease (CVD). Aquatic exercise is being considered as a co-adjuvant form of rehabilitation, but there is limited evidence for its cardiovascular risk-reduction properties for older people. Our study aimed to address this by exploring the cardiovascular effects of long-term aquatic exercise in older adults in comparison to those who are either inactive or engaged in land-based/mixed training by measurement of micro- and macro-circulation. Flow Mediated Dilatation (FMD) was the primary outcome.MethodsThis was a pragmatic, 4-group, cross-sectional study. Eighty normotensive adults constituted four (n = 20) groups. The Aqua group (aged 63.7 ± 7 years) and Land group (aged 65 ± 6 years) consisted of participants engaged in aquatic and land-based training, respectively. The mixed group (Mix) (aged 66 ± 6 years) consisted of participants engaged in both land-based and aquatic training. Self-reported training consisted of ≥2/week for ≥6 months (mean sessions/week = 4 ± 1, 4 ± 1, and 5 ± 2 for each group, respectively). The sedentary group (Sed) (aged 63 ± 6 years) consisted of people who were sedentary for ≥6 months (mean sessions/week 0 ± 0). The primary outcome was %FMD. Secondary outcomes included raw cutaneous vascular conductance (CVC) and CVC max.ResultsStatistically significant differences (%FMD, raw CVC variables other than baseline) were found between each of the exercise groups (Aqua, Land, Mix) and the sedentary group (Sed) (i.e., 11.2 (4.2) vs. 5.0 (2.3); p < 0.0005, between the Aqua group and Sed group, for %FMD). No specific advantage could be attributed to any one of the exercise groups.ConclusionWe reported improvements in NO-mediated endothelial function at micro- and macro-circulatory levels, observing no differences between exercise modes. Our findings provide evidence for the role of aquatic exercise as a “shield” against CVD in older populations.
Highlights
Cardiovascular aging is implicated in the development of cardiovascular disease (CVD)
Our study indicates that long-term, water-based exercise in older individuals can offer improvements in macrovascular function parameters, which are associated with CVD risk reduction, such as %Flow Mediated Dilatation (FMD) (Klonizakis et al, 2017)
The fact that all of our study participants were engaging in regular exercise (4 times per week on average), should not be overlooked: it is known that regular moderate physical activity promotes an antioxidant state and preserves endothelial function, eliciting systemic molecular pathways connected with angiogenesis and chronic anti-inflammatory action (Di Francescomarino et al, 2009) Our work suggests that irrespective of the mechanisms involved, benefits are similar between land, water- and mixed-mode based, aerobic exercise regimes, provided that a training program is followed regularly
Summary
Cardiovascular aging is implicated in the development of cardiovascular disease (CVD). Aquatic exercise is being considered as a co-adjuvant form of rehabilitation, but there is limited evidence for its cardiovascular risk-reduction properties for older people. Cardiovascular aging appears to affect pathophysiological pathways implicated being in the development of cardiovascular disease (CVD). This is why advanced age is one of the most important CVD risk factors. Participation in exercise in older populations is low and decreases as age increases, i.e., only 13% of women over 75 meet the U.K. physical activity recommendations (Townsend et al, 2015). Interventions based on forms of exercise that older people feel comfortable with and in which they are keen to participate, need to be promoted
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