Measures Of Cardiovascular Health Research Articles

2706 km cycling in 2 weeks: effects on cardiac function in 6 elderly male athletes

ABSTRACTObjectives: Physiological effects of exercise on trained and untrained individuals have been studied extensively. Typically, young or middle-aged individuals are examined before and after short periods of vigorous exertion.Methods: We studied 6 elderly male athletes (61 ± 8 years (mean ± SD); baseline O2max 48 ± 5 ml·kg−1·min−1) with focus on cardiac function and biomarkers following 14 consecutive days of moderate intensity exercise. Cardiac dimensions, function, biomarkers, and other measures of cardiovascular health were examined at baseline and 2 and 28 h after the last day of cycling a total of 2706 km.Results: Data collected after the cessation of exercise on the 14th day revealed significant increases in average size of the left atrium (3.5 ± 0.4 to 4.0 ± 0.3 cm; p = 0.02) and left ventricular end systolic volume (47 ± 2 to 52 ± 5 ml; p = 0.004), with no other significant changes in cardiac size or function. Small, transient increases in cardiac biomarkers (troponin T, creatine kinase myocardial band, and N-terminal pro-brain natriuretic peptide) (p < 0.01) were observed 2 h after completion of cycling but no changes in systolic (including strain-analyses) or diastolic cardiac function were observed at rest. O2max was significantly lower at the 28 h time point than at baseline (p < 0.02). Plasma concentrations of total- (p < 0.01) and low-density lipoprotein-cholesterol (p < 0.01) were markedly lower after exercise. Systolic blood pressure was unchanged, but diastolic pressure was significantly lower after exercise than at baseline.Conclusions: The results suggest that repeated moderate intensity exercise in elderly men was associated with a transient increase in cardiac biomarkers while cardiac function remained unaltered. A favorable reduction in blood lipids and diastolic blood pressure were seen for >28 h after the end of activity. An unexplained symptomless severe plasma hyponatremia developed in 3 of 6 subjects 28 h after the end of activity.

Fatness and Fluctuating Body Weight: Effect on Central Vasculature.

Weight Cycling (WC) is a prevalent behavior associated with adverse cardiovascular (CV) health. However, a 2010 review on the effects of WC and blood pressure (BP) determined that there was not enough evidence to draw definitive conclusions. Central BP is the principal predictor of CV risk compared to peripheral BP. The influence that WC may have specifically on central BP is unknown. Cross-sectional observation of self-reported history of WC on measures of CV health was undertaken. Seventy-five women completed a Weight and Lifestyle Inventory questionnaire, which is considered a reliable index of WC (r = 0.87, p < 0.001). Measures of visceral fat, BP, arterial stiffness, and VO2peak were taken. Regression equations were used to assess primary predictors of these outcomes. Seventy-five middle aged (39 ± 11 years), obese (32 ± 7 kg/m2), and relatively unfit (24 ± 8 ml·kg−1 min−1) women completed the study. Visceral fat was the strongest predictor of brachial systolic blood pressure (SBP; r2 = 0.283), brachial diastolic blood pressure (DBP; r2 = 0.176), central SBP (r2 = 0.375), and augmentation index (AIx; r2 = 0.535, all p < 0.001). VO2peak was the strongest predictor of central DBP (r2 = 0.062, p = 0.036) and augmentation pressure (AP; r2 = 0.491, p < 0.001). Weight cycling index was associated with visceral fat (r = 0.521, p < 0.001). Visceral fat was a mediator between WC and central SBP (confidence interval [CI] = 0.0053–0.0602), AP (CI = 0.0507–0.4915), AIx (CI = 0.0025–0.0699), and carotid-femoral pulse wave velocity (CI = 0.0115–0.1227; all p < 0.05). WC may increase visceral fat accumulation, which was associated with increased central SBP and measures of arterial stiffness.

Changes in Cardiovascular Health Following Exercise in Older Men and Women at Risk for Dementia

PURPOSE: To investigate the effects of a 24-week multiple-modality exercise intervention with additional mind-motor training on cardiovascular health and fitness. The secondary objective was to investigate whether the intervention had gender-specific effects on the study outcomes. METHODS: Community-dwelling older adults (n = 127, age = 67.5 [7.3] yr, 71% women) were randomized to a 45-min multiple-modality exercise intervention with additional 15 minutes of either mind-motor training (M4 group) or an active control intervention (15 minutes of balance, range of motion and breathing exercises, [M2 group]). Assessment occurred at: baseline, 24 weeks (intervention endpoint), and 52 weeks (after a 28-week no-contact follow-up). The study outcomes were: predicted maximal oxygen consumption (pVO2max), automated office blood pressure (BP), carotid atrial compliance (cAC), intima-media thickness (cIMT), as well as body weight. Mixed between-within ANOVA was used to examine: i) main effects of time (baseline vs 24 weeks), intervention group (M4 vs M2) and gender (men vs women); ii) interactions of time x intervention group, and time x gender. RESULTS: Results at 24 weeks: both M4 and M2 demonstrated improvements in pVO2max (p<.001), with no interaction effects for group or gender (all p>.05). For BP measures, both groups showed reduction in systolic (p<.001) and diastolic (p=.001) BP, with no interaction effect for intervention group; however, women showed greater reduction in diastolic BP compared to men (p=.02). No significant changes were observed in cIMT, cAC, or body weight. Results at 52 weeks: improvements in pVO2max were retained (p<.001), however, the M4 group showed higher pVO2max when compared to M2 (p=.005), with no interaction effects for gender. Significant reduction in systolic BP (p<.001) was observed for both M4 and M2, with no interaction effects for group or gender. For diastolic BP, M4 showed significant reduction compared to M2 (p=.04); women also demonstrated greater reduction compared to men (p=.02). There was no significant change in cIMT, cAC or body weight. CONCLUSION: Our results suggest that women may be more likely to benefit from group-based, multiple-modality exercise programs in measures of cardiovascular health.

Abstract P347: Association Between Sleep Patterns and the American Heart Association Life’s Simple 7 Among Women

Introduction: The American Heart Association’s Life’s Simple 7 (AHA LS7) is a measure of cardiovascular health that evaluates seven lifestyle behaviors and clinical risk factors to track the population’s progress towards the AHA 2020 strategic goals. Sleep is an emerging lifestyle risk factor for cardiovascular disease that is not currently included in the AHA LS7. Our aim was to assess the relation of sleep with the AHA LS7 within a diverse sample of women. Hypothesis: We hypothesized that a longer sleep duration, good sleep quality, low risk for obstructive sleep apnea (OSA), and absence of insomnia and snoring would be associated with a higher global AHA LS7 score and its component scores, as measures of compliance to overall and individual AHA LS7 guidelines. Methods: Baseline data from the AHA Go Red for Women Strategically Focused Research Network cohort at Columbia University Medical Center, an ongoing prospective study, were examined (n=323, &gt;50% minority/Hispanic, mean age: 39y, range: 20-76y). Sleep was self-reported using validated questionnaires. A standardized scoring system was used to compute the global AHA LS7 score using criteria for smoking, diet, physical activity, body mass index (BMI), blood pressure (BP), total cholesterol, and fasting glucose. Women received a score of 2 (optimal), 1 (average), or 0 (poor) based on their compliance with each AHA LS7 guideline. The seven component scores were summed to create the global AHA LS7 score. T-tests, Fischer’s exact test and multivariable-adjusted regression models were used to evaluate associations between sleep and the global AHA LS7 score and its components. Results: The median global AHA LS7 score was 10; 31.3%, 33.3% and 35.3% of women had a score of 0-8 (poor), 9-10 (average), and 11-14 (optimal), respectively. Participants with sleep duration ≥7 hours, lack of insomnia and snoring, and low risk for OSA were more likely to meet ≥4 of the AHA LS7 metrics (p≤0.04). Those with sleep duration ≥7 hours, good sleep quality, no insomnia and snoring, and at low risk of OSA were more likely to meet the AHA LS7 optimal guideline for physical activity, BMI, BP, glucose, and cholesterol (p≤0.04). In multivariable-adjusted linear regression models, a lower global AHA LS7 score was associated with a higher Pittsburgh Sleep Quality Index, indicative of poorer sleep quality (β=-0.08, p=0.019), higher insomnia severity index (β=-0.05, p=0.027), and higher risk for OSA (β=-0.84, p=0.016). Conclusions: In this cohort of women, better sleep habits were associated with meeting the AHA LS7 guidelines. Our results warrant confirmation in larger prospective studies and within other population groups, but nonetheless highlight the potential importance of screening for sleep habits in conjunction with other lifestyle behaviors to identify those at risk of cardiovascular disease.

Effects of strength training on selected physiological variables among basketball players

Introduction: The current study is on how 12 weeks of strength training impacts several physiological features in elite basketball players. The New Public School, Sec-18, and Sri Guru Harkrishan Model School, Sec-38, both in Union Territory Chandigarh, each had twenty basketball players recruited at random. Students' ages varied from 16 to 19. Each team contained 10 participants, and they were distributed equally between the strength training and control groups.Method: This research used a completely random group design. The Strength training group's workouts were planned for 1.5 hours twice a week (on Tuesdays and Fridays). The control group was not allowed to take part in any of the training programmes beyond the normal, everyday practice they were already engaged in. Pulse rate at rest, systolic blood pressure, diastolic blood pressure, respiratory rate at rest, and peak expiratory flow rate were the physiological variables used for the research.Results: The ’t’ test was calculated using SPSS with a significance threshold of 0.05 to examine the mean difference between the pre- and post-tests. Measures of cardiovascular health, including heart rate, blood pressure, and respiratory rate at rest, showed statistically significant improvement between the pre- and post-test periods.Conclusion: It has been concluded that strength training has a positive effect on the physiological variables. Physiological variables in the control group showed no significant change between the pre- and post-test. Therefore, athletes should make this exercise a regular component of their schedules.

Physical Fitness, Grit, School Attendance, and Academic Performance among Adolescents.

Objective The purpose of this study was to examine the relationship of grit as a construct representing perseverance to overcoming barriers and the total number of school absences to academic performance (AP) while controlling for sociodemographics, fitness (i.e., PACER), and Body Mass Index (BMI). Methods Adolescents (N = 397, SD = 1.85; 80.9% females; 77.1% Hispanic) from an urban, minority-majority city in the Southern United States completed the FitnessGram® assessment of physical fitness (e.g., aerobic capacity and Body Mass Index (BMI)) and the valid and reliable short grit survey. The schools provided sociodemographics, attendance, and AP data for the adolescents. Results Adolescents with higher grit scores (rs = 0.21, P < 0.001) and less total absences (rs = −0.35, P < 0.001) performed better on AP. Hierarchical multiple regression indicated that grit and absences were associated with AP (β = 0.13, P < 0.01 and β = −0.35, P < 0.001, resp.). Conclusions Grit and a total number of absences are significant contributors to academic success, particularly among Hispanic adolescents. Further, grit and school attendance may serve as a better measure of protective factors over proximal health measures of cardiovascular health and BMI.

Aortic hemodynamics in postmenopausal women following cessation of hormone therapy.

Central (aortic) blood pressure and aortic pulse wave characteristics are measures of cardiovascular health, predictive of cardiovascular mortality. Previous studies have compared aortic hemodynamics in women who do and do not take menopausal hormone therapy, but characteristics of these parameters following cessation of treatment have not been defined. Therefore, the purpose of this study was to define aortic pulse wave characteristics in postmenopausal women with and without a history of menopausal hormone therapy use. Pulse wave analysis was conducted on 67 women who had participated in the randomized, double‐blind, placebo‐controlled Kronos Early Estrogen Prevention Study (KEEPS), 3 years subsequent to the four‐year treatment period. Treatment was oral conjugated equine estrogen (0.45 mg/day; n = 18); transdermal 17β‐estradiol (50 μg/day; n = 23) each with oral micronized progesterone (Prometrium 200 mg); and placebo pills and patch (n = 26). At post‐treatment, median age (60 years) and body mass index (27 kg/m2) did not differ across prior treatment assignment. Aortic blood pressures (median systolic 115 mm Hg and diastolic 76 mm Hg) and augmentation index (median 33%) did not differ among women across prior treatment assignment. These results suggest that these doses and formulations of menopausal hormone therapy had no long‐term effects on central vascular function 3 years after cessation of treatment.

Cardioprotective Benefits Associated With Routine Physical Activity In Middle Aged Population

PURPOSE: It is well known that routine intensive physical activity (PA) will result in positive cardiovascular adaptations. Similarly, it is known that aging will cause decrements in similar common measures of cardiovascular health. However, there is only limited data on the cardiovascular performance of an older, presumably healthy, physically active population who have remained active for decades. METHODS: Thirteen masters level swimmers (MS) and eight controls (IC) (54.3 ± 12.7yrs and 57.5 ± 7.9yrs; respectively) were asked to wear an ambulatory heart rate monitor (Actiheart) for seven consecutive days. Subjects were partitioned based upon self-reported long-term physical activity and asked to maintain their normal daily activities for the entirety of the data collection period. Heart rate was collected during waking hours (14.8 ± 3.2 hrs). All HR data was verified via accelerometer. To measure HRpeak and estimate cardiovascular fitness level, subjects completed a 1-mile timed walk. Independent two-sample t-tests were used for all comparisons, significance set at p<0.05. RESULTS: Mean daily HRmin and HRavg was lower in MS than IC (54 ± 5 vs 67 ± 8bpm, 72 ± 8bpm vs. 83 ± 9bpm; p<0.05, respectively) while mean daily HRmax was higher in MS (139 ± 18bpm vs. 131 ± 19bpm; p<0.05). Mean daily HRmax was higher than HRpeak during the 1-mile test for MS (139 ± 19 vs. 123 ± 20bpm; p<0.05) but not for IC (131 ± 18 vs. 135 ± 18; p = 0.69). CONCLUSIONS: Persistent participation in routine physical activity at any age appears to result in training induced changes consistent with improved cardiovascular health. Results from the present study, however, suggest that a 1 mile walk may not be an appropriate test for the physically active as it tends to underestimate maximum values for heart rate.

Fire Simulation and Cardiovascular Health in Firefighters.

Background:Rates of myocardial infarction in firefighters are increased during fire suppression duties, and are likely to reflect a combination of factors including extreme physical exertion and heat exposure. We assessed the effects of simulated fire suppression on measures of cardiovascular health in healthy firefighters.Methods:In an open-label randomized crossover study, 19 healthy firefighters (age, 41±7 years; 16 males) performed a standardized training exercise in a fire simulation facility or light duties for 20 minutes. After each exposure, ex vivo thrombus formation, fibrinolysis, platelet activation, and forearm blood flow in response to intra-arterial infusions of endothelial-dependent and -independent vasodilators were measured.Results:After fire simulation training, core temperature increased (1.0±0.1°C) and weight reduced (0.46±0.14 kg, P<0.001 for both). In comparison with control, exposure to fire simulation increased thrombus formation under low-shear (73±14%) and high-shear (66±14%) conditions (P<0.001 for both) and increased platelet-monocyte binding (7±10%, P=0.03). There was a dose-dependent increase in forearm blood flow with all vasodilators (P<0.001), which was attenuated by fire simulation in response to acetylcholine (P=0.01) and sodium nitroprusside (P=0.004). This was associated with a rise in fibrinolytic capacity, asymptomatic myocardial ischemia, and an increase in plasma cardiac troponin I concentrations (1.4 [0.8–2.5] versus 3.0 [1.7–6.4] ng/L, P=0.010).Conclusions:Exposure to extreme heat and physical exertion during fire suppression activates platelets, increases thrombus formation, impairs vascular function, and promotes myocardial ischemia and injury in healthy firefighters. Our findings provide pathogenic mechanisms to explain the association between fire suppression activity and acute myocardial infarction in firefighters.Clinical Trial Registration:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01812317.

Predictors of Cardiovascular Health in Older Adults: a Regression Tree Analysis

BackgroundCardiovascular health is central to overall health. Studies on predictors of cardiovascular health in older adults have not fully considered potential interactions among predictor variables.ObjectiveThe purpose of this study was to determine the relationships of lifestyle behaviors and body composition with cardiovascular health in older adults while accounting for potential interactions among lifestyle behaviors, measures of body composition and socio demographic characteristics.MethodsThe Health, Aging and Body Composition (Health ABC)Study is a prospective cohort study of 3,075 adults aged 70 to 79 at baseline. The Generalized, Unbiased, Interaction Detection and Estimation (GUIDE) algorithm for regression tree analysis was used to predict measures of cardiovascular health, including high‐density lipoprotein (HDL) cholesterol, interleukin‐6 (IL‐6), homeostasis model assessment of insulin resistance (HOMA‐IR), and systolic blood pressure (SBP), of Health ABC participants based on their lifestyle behaviors, measures of body composition and socio demographic characteristics.ResultsParticipants with the highest mean HDL cholesterol had trunk lean mass ≤21.6 kg and abdominal visceral fat ≤96.2 cm2, while those with the lowest HDL cholesterol had trunk lean mass &gt;27.8 kg. Persons with the lowest IL‐6 had a sagittal diameter ≤24.7 cm (or had missing values for sagittal diameter) and flossed their teeth at least 3 times per week, while those with the highest IL‐6 had a sagittal diameter &gt;24.7 cm. Persons with the lowest HOMA‐IR had a BMI ≤27.4 kg/m2 (or had missing values for BMI), while those with the highest HOMA‐IR had a BMI &gt;27.4 kg/m2 and a sagittal diameter &gt;27.1 cm. Participants with the lowest SBP were those who were not on (or had missing data on) blood pressure medication, were from the Memphis clinical site and were white, while those with the highest SBP were those on high blood pressure medication from the Pittsburgh site.ConclusionThis study provides further evidence that abdominal adiposity is strongly linked to cardiovascular risk in older adults and supports the use of sagittal diameter as an indicator of cardiovascular health. It also suggests a strong inverse relationship between lean body mass and HDL cholesterol, which warrants further investigation.Support or Funding InformationThis research is supported by USDA‐ARS Specific Cooperative Agreement 8040‐53000‐018‐08. This study is also supported in part by National Institute on Aging (NIA) Contracts N01‐AG‐6‐2101;N01‐AG‐6‐2103; N01‐AG‐6‐2106; NIA grant R01‐AG028050, NINR grant R01‐NR012459, and by the Intramural Research Program of the NIH, NIA.

The moderating effect of perceived organizational support on the relationships between organizational justice and objective measures of cardiovascular health

ABSTRACTThis paper builds on a recent meta-analytic review on the relationships between organizational justice and health. Specifically, we examine the moderating role of perceived organizational support (POS) on the relationships between organizational justice and three objective cardiovascular health measures, namely, heart rate, systolic blood pressure, and diastolic blood pressure, among a population of 290 public construction workers. The interaction between justice and POS was statistically significant using procedural justice, demonstrating that procedural justice is associated with improvements in the three health outcomes only when POS is relatively high. In other words, higher levels of both procedural justice and POS were needed for reduced heart rate and reduced systolic and diastolic blood pressure. However, the interaction between distributive justice and POS did not significantly relate to the health outcomes. This study makes a contribution to the field by focusing the effects of psychosocial workplace variables on measures of cardiovascular health, and demonstrating an important boundary condition of the relationships between procedural justice and cardiovascular risk factors.

Cardiovascular Risk Factors and Masked Hypertension: The Jackson Heart Study.

Masked hypertension is associated with increased risk for cardiovascular disease. Identifying modifiable risk factors for masked hypertension could provide approaches to reduce its prevalence. Life's Simple 7 is a measure of cardiovascular health developed by the American Heart Association that includes body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), cholesterol, and glucose. We examined the association between cardiovascular health and masked daytime hypertension in the Jackson Heart Study, an exclusively African American cohort. Life's Simple 7 factors were assessed during a study visit and categorized as poor, intermediate, or ideal. Ambulatory BP monitoring was performed after the study visit. Using BP measured between 10:00 am and 8:00 pm on ambulatory BP monitoring, masked daytime hypertension was defined as mean clinic systolic BP/diastolic BP <140/90 mm Hg and mean daytime systolic BP/diastolic BP ≥135/85 mm Hg. Among the 758 participants with systolic BP/diastolic BP <140/90 mm Hg, 30.5% had masked daytime hypertension. The multivariable-adjusted prevalence ratios for masked daytime hypertension comparing participants with 2, 3, and ≥4 versus ≤1 ideal Life's Simple 7 factors were 0.99 (95% confidence interval [CI], 0.74-1.33), 0.77 (95% CI, 0.57-1.03), and 0.51 (95% CI, 0.33-0.79), respectively. Masked daytime hypertension was less common among participants with ideal versus poor levels of physical activity (ratio, 0.74; 95% CI, 0.56-1.00), ideal or intermediate levels pooled together versus poor diet (prevalence ratio, 0.73; 95% CI, 0.58-0.91), ideal versus poor levels of cigarette smoking (prevalence ratio, 0.61; 95% CI, 0.46-0.82), and ideal versus intermediate levels of clinic BP (prevalence ratio, 0.28, 95% CI, 0.16-0.48). Better cardiovascular health is associated with a lower preva lence of masked hypertension.

Abstract 12222: Patient-Reported Health and its Correlates in Adults With Congenital Heart Disease From 15 Countries

Objectives: The importance of patient-reported health assessment as a critical measure of cardiovascular health has been emphasized. In adults with congenital heart disease (ConHD), geographic differences in patient-reported health are assumed, but international studies using a uniform methodology are non-existent. We sought (1) to explore patient-reported health in an international sample of adults with ConHD, and (2) to investigate the association between patient characteristics and patient-reported health. Methods: In a cross-sectional study, 4,028 patients (median age=32 y; 53% women; 26% mild, 48% moderate, 26% complex defects) from 15 countries worldwide were included. Patient-reported health was assessed using the SF-12, yielding a Physical Component Summary (PCS) and a Mental Component Summary (MCS). Patient characteristics included sex, age, marital status, educational level, employment status, ConHD complexity, and patient-reported New York Heart Association (NYHA) class. Multivariable linear regression analysis was performed. Results: Mean PCS was 77.2 ±20.9 and mean MCS was 72.1 ±19.0, on a scale 0-100. Fig 1 shows the PCS and MCS per country (flags) and per disease complexity (lines). Malta and Sweden have the highest scores; and France, Taiwan and India have the lowest scores. Lower PCS (worse physical health) was significantly associated with female sex; older age; lack of employment; being divorced or widowed; less education; greater disease complexity; and worse NYHA class (adj. R 2 =0.512). Lower MCS (worse mental health) was significantly related to female sex; lack of employment; being divorced or widowed; having complex ConHD; and worse NYHA class (adj. R 2 =0.234). Conclusions: International variation in patient-reported health is confirmed. The detection of both medical and sociodemographic correlates of perceived health status allow clinicians to identify patients at risk for poor health and to target resources accordingly.

Associations Between Cardiovascular Health and Health-Related Quality of Life, Behavioral Risk Factor Surveillance System, 2013.

IntroductionThe American Heart Association established 7 cardiovascular health metrics as targets for promoting healthier lives. Cardiovascular health has been hypothesized to play a role in individuals’ perception of quality of life; however, previous studies have mostly assessed the effect of cardiovascular risk factors on quality of life.MethodsData were from the 2013 Behavioral Risk Factor Surveillance System, a state-based telephone survey of adults 18 years or older (N = 347,073). All measures of cardiovascular health and health-related quality of life were self-reported. The 7 ideal cardiovascular health metrics were normal blood pressure, cholesterol, body mass index, not having diabetes, not smoking, being physically active, and having adequate fruit or vegetable intake. Cardiovascular health was categorized into meeting 0–2, 3–5, or 6–7 ideal cardiovascular health metrics. Logistic regression models examined the association between cardiovascular health, general health status, and 3 measures of unhealthy days per month, adjusting for age, sex, race/ethnicity, education, and annual income.ResultsMeeting 3 to 5 or 6 to 7 ideal cardiovascular health metrics was associated with a 51% and 79% lower adjusted prevalence ratio (aPR) of fair/poor health, respectively (aPR = 0.49, 95% confidence interval [CI] [0.47–0.50], aPR = 0.21, 95% CI [0.19–0.23]); a 47% and 72% lower prevalence of ≥14 physically unhealthy days (aPR = 0.53, 95% CI [0.51–0.55], aPR = 0.28, 95% CI [0.26–0.20]); a 43% and 66% lower prevalence of ≥14 mentally unhealthy days (aPR = 0.57, 95% CI [0.55–0.60], aPR = 0.34, 95% CI [0.31–0.37]); and a 50% and 74% lower prevalence of ≥14 activity limitation days (aPR = 0.50, 95% CI [0.48–0.53], aPR = 0.26, 95% CI [0.23–0.29]) in the past 30 days.ConclusionAchieving a greater number of ideal cardiovascular health metrics may be associated with less impairment in health-related quality of life.

Acute effects of quercetin-3-O-glucoside on endothelial function and blood pressure: a randomized dose-response study

Epidemiologic studies have suggested that a flavonoid-rich diet can reduce the risk of developing cardiovascular disease. Certain flavonoids, in particular quercetin, have been shown to ameliorate endothelial dysfunction and reduce blood pressure (BP), possibly by increasing the bioavailability of the potent vasodilator nitric oxide (NO). Several studies have indicated that improvements in measures of cardiovascular health do not occur linearly, but rather, plateau or decrease with an increasing dose of flavonoids. We determined whether the acute administration of increasing doses of a common quercetin glycoside (quercetin-3-O-glucoside) improves endothelial function and reduces BP in a dose-dependent manner. We also explored whether any effects were correlated with changes in plasma NO production. A randomized, controlled, crossover study was performed in 15 healthy volunteers who each completed 5 visits with a minimum washout period of 1 wk between testing days. Participants received each of the following 5 interventions in a random order: 1) 0, 2) 50, 3) 100, 4) 200, or 5) 400 mg quercetin-3-O-glucoside. Endothelial function and BP were assessed before and 60 min after intervention. A blood sample was taken before and 90 min after intervention for the analysis of plasma nitrate and nitrite as markers of NO production as well as of plasma quercetin metabolites. Although we observed a significant correlation between the dose of quercetin-3-O-glucoside and plasma concentrations of total quercetin (R(2) = 0.52, P < 0.001) and isorhamnetin (R(2) = 0.12, P = 0.005), we showed no improvements in endothelial function or BP and no changes in NO production after any dose. From these results, we conclude that there are no acute changes in BP or the NO-mediated endothelium-dependent relaxation of the brachial artery with doses of quercetin ranging from 50 to 400 mg in healthy men and women. This trial was registered at www.anzctr.org.au as ACTRN12615001338550.

Effects Of A Short-term Functional Exercise Program On Cardiac And Vascular Health

Cardiovascular disease is the leading cause of death in the United States. Research consistently shows that those at the highest risk for cardiovascular disease are those who are overweight and have low fitness and activity levels. Also, physical activity levels are inversely related to glucose and cholesterol, body fat, and vascular health measures; all of which are easily measured markers of cardiovascular disease. Previous studies have found that short-term exercise improves blood pressure, vascular health, and glucose and cholesterol levels. Also, fun and simple exercises have been shown to lead to habit formation in previously sedentary individuals. However, to date, no study has examined cardiac and vascular health changes with a 4-week functional exercise program. PURPOSE: To determine if a 4-week self-report functional exercise intervention will improve cardiovascular health measures. METHODS: Eleven seemingly healthy adults (8 M, 3 F) have completed the 4-week exercise program. Blood pressure, blood glucose and cholesterol levels, body fat, carotid artery intima media thickness (IMT), and brachial artery flow-mediated dilation (FMD) were measured after an overnight fast, pre- and post- intervention. For the intervention, three times a week, participants completed a 6-station exercise circuit, rotating through the stations 3 times. The circuit included functional exercises such as weighted carries, stair climbs, balance, and core strength. RESULTS: Participants’ average age was 32.0 ±16 yrs, and body weight was 156.6 ±28.8 lbs. Adherence to the four-week exercise program was 95.5%. We found improvements in cardiovascular health measures; including a decrease in total cholesterol (-10.45 ±20 mg/dL), an increase in HDL levels (2.45 ±7 mg/dL), a decrease in triglyceride levels (-7.10 ±41 mg/dL), a significant decrease in LDL levels (-18.4 ±9 mg/dL, p= 0.01), an increase in percent FMD (2.36 ±5%), a decrease in IMT measurements (-0.01 ±0.03 mm), a decrease in fat mass (-1.46 ±5 lb), an increase in fat free mass (2.05 ±4 lb), and a decrease in body fat percent (-0.63 ±3%). CONCLUSION: Our results suggest improvements in cardiovascular health measures; however, additional data collection is necessary in order to see more significant results. Data collection is ongoing.

Abstract MP45: Effects of an mHealth Adaptive Intervention on Vascular Health and Cardiorespiratory Fitness

Introduction: Behavioral economics-based interventions for increasing steps/day may improve cardiorespiratory fitness (CRF; Peak O2 uptake - VO2peak), central/aortic blood pressure, and vascular stiffness. The purpose of this study was to examine the effects of adaptive (Ad) physical activity (PA) goals (daily step goals based on prior 10-day window and a percentile algorithm) vs. static (St) PA goals (10,000 steps/day) combined with either immediate (Im) financial micro-incentives or delayed (De) incentives (Groups: Ad+Im; Ad+De; St+Im; St+De) on VO2peak, blood pressure and vascular stiffness. We hypothesized that participants randomized to adaptive goals with immediate reinforcement (Ad+Im) would have greater improvements in cardiovascular health measures than participants assigned to static goals and/or delayed reinforcement conditions (active controls). Methods: Inactive adults (Age = 41.8 ± 6.7yrs; BMI = 34.5 ± 6 kg/m2) were randomized to an adaptive/static goal intervention with either immediate micro-incentives or delayed incentives in a 4-month factorial RCT to improve steps/day. Additionally, all four groups received daily text-message prompts-to-action and Fitbit ZipTM activity monitors. Pre and post VO2peak (n=81) were estimated using a modified, sub-maximal Balke treadmill protocol while central blood pressures, augmentation index (Aix@75) (n=70) and carotid-femoral pulse wave velocity (cf-PWV) (n=64) were assessed with the Sphygmocor XCELTM device. Between- and within-group differences were examined using linear mixed models, adjusted for sex, age, race/ethnicity, and smoking history. Alpha was set at 0.05, and data are presented as estimated marginal means ± standard errors (SE). Results: All groups improved from pre to post, but we found no significant between-group differences in the degree of improvement. Across all groups, we found the following: VO2peak and all vascular markers improved significantly pre to post intervention (p&lt;0.05). VO2peak improved by ~5% (pre = 24.9 ± 0.65 vs. post = 26.3 ± 0.66 ml/kg/min). Central systolic blood pressures (cSBP) decreased (cSBP pre = 117.5 ± 2.1 vs. post = 113.1 ± 2.2 mmHg). Cf-PWV (pre = 7.5 ± 0.18 vs. post = 7.3 ± 0.18 m/sec) and AIX@75 (pre =14.1 ± 2.2 vs. post = 11.4 ± 2.2) decreased. Conclusion: Cardiorespiratory fitness and markers of vascular health improved when participants were simply provided a Fitbit and prompted daily to be more physically active, regardless of incentive or goal-setting approach. Implications for designing behavioral interventions for cardiovascular risk reduction will be discussed.

Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players.

Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3 ± 0.5 mm versus 3.7 ± 0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2 ± 6.4 mmHg versus 122.4 ± 6.8 mmHg), submaximal exercise (150.4 ± 18.8 mmHg versus 137.3 ± 9.5 mmHg), maximal exercise (211.3 ± 25.9 mmHg versus 191.4 ± 19.2 mmHg), and 24-hour BP (124.9 ± 6.3 mmHg versus 109.8 ± 3.7 mmHg). Football players also had higher fasting glucose (91.6 ± 6.5 mg/dL versus 86.6 ± 5.8 mg/dL), lower HDL (36.5 ± 11.2 mg/dL versus 47.1 ± 14.8 mg/dL), and higher body fat percentage (29.2 ± 7.9% versus 23.2 ± 7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk.

Abstract 13332: Ideal Cardiovascular Health Metrics Are Associated With Disability Independently of Vascular Conditions

Background: Individuals with disability comprise the largest health care consumer group in the US. Vascular and non-vascular conditions contribute independently to disability, but it is unclear whether vascular risk factors are associated with disability independently of vascular events. We examined whether the American Heart Association’s 7 ideal cardiovascular health (CVH) metrics were independently associated with disability in a nationally representative cohort. Methods: Adults age&gt;=20 years from the National Health and Nutrition Examination Survey 2005-2012 were included. Ideal CVH was calculated as a composite of 7 measures, each scored from 0-2. Primary predictors were number of ideal CVH metrics and score of CVH metrics. The outcome was a dichotomous score from 20 activities of daily living (ADL) and instrumental ADLs. Unadjusted and adjusted weighted logistic models estimated associations between ideal CVH and disability. Secondarily, interactions were tested and each disability item was tested separately. Results: The total cohort included 22692 participants; mean age was 46.9 years. Cardiac disease and stroke were present in 6.6% and 2.8%; 90.3% had poor physical activity and 89.9% poor diet. Among 3975 individuals with full data on all 7 CVH metrics, the mean number of ideal CVH metrics was 3.12 (95% CI 3.05-3.20) and ideal CVH score was 7.6 (7.5-7.7). In fully adjusted models, the OR for disability was 0.90 (95% CI 0.83-0.98) per point increase in ideal CVH score, and 0.84 (0.73-0.97) per additional number of ideal CVH metrics. There were significant interactions with ideal CVH measures for cardiac disease (p =0.007 for ideal CVH score and 0.01 for number of ideal CVH indicators) and stroke (p= 0.12 and 0.11 respectively). Among those with cardiac disease and stroke, there was a paradoxical trend for increased odds of disability for increasing values of CVH. For the majority of disability items, there was an inverse relationship with ideal CVH metrics. Conclusions: Both ideal CVH score and number of ideal CVH metrics were strongly and significantly associated with reduced odds of disability independently of vascular and non-vascular conditions. Poorer CVH may cause subclinical vascular disease resulting in disability.

PGE2, Kidney Disease, and Cardiovascular Risk

An important measure of cardiovascular health is obtained by evaluating the global cardiovascular risk, which comprises a number of factors, including hypertension and type 2 diabetes, the leading causes of illness and death in the world, as well as the metabolic syndrome. Altered immunity, inflammation, and oxidative stress underlie many of the changes associated with cardiovascular disease, diabetes, and the metabolic syndrome, and recent efforts have begun to elucidate the contribution of PGE2 in these events. This review summarizes the role of PGE2 in kidney disease outcomes that accelerate cardiovascular disease, highlights the role of cyclooxygenase-2/microsomal PGE synthase 1/PGE2 signaling in hypertension and diabetes, and outlines the contribution of PGE2 to other aspects of the metabolic syndrome, particularly abdominal adiposity, dyslipidemia, and atherogenesis. A clearer understanding of the role of PGE2 could lead to new avenues to improve therapeutic options and disease management strategies.