Sedentary Elderly Subjects Research Articles

Heart failure compromises muscle power of lower limbs of sedentary elderly people

Purpose. To analyze and to compare the absolute and relative muscle power of the lower limbs in sedentary elderly subjects with and without heart failure. Methods. The study included 36 elderly subjects (72 ± 6.5 years, 76.8 ± 4.8 kg, 171 ± 9.4 cm) divided into two groups: sixteen patients with heart failure versus twenty patients with coronary artery disease, but without heart failure. The muscle power of the lower limbs was assessed with a half-squat exercise; three repetitions were performed with three seconds of the interval between repetitions as fast as possible in the concentric phase. For the statistical analysis, unpaired Student's t-tests were used to compare the absolute and relative muscular power between groups. Results. Subjects without heart failure had significantly greater absolute (362 ± 18.5 W vs. 438 ± 22.3 W, p = 0.015) and relative (4.6 ± 0.2 W / kg vs. 5.9 ± 0.2 W / Kg, p = 0.001) muscle power versus subjects with heart failure. Conclusion. Heart failure harms the muscular power of the lower limbs in the elderly, which may influence the prognosis and evolution of the disease and capacity functional.

The effect of home-based exercise in sleep quality and excessive daytime sleepiness in elderly people: A protocol of randomized controlled clinical trial

Background: Sleep-disordered breathing is associated with significant morbidity and mortality, presenting a high prevalence in the general population and being considered today as an important public health problem worldwide, affecting about 45% of the world population. It is estimated that about from 50 to 75% of the elderly complain of difficulties in initiating or maintaining sleep. The regular practice of physical exercise of mild to moderate intensity is associated with improved sleep quality in the elderly and has increased its recommendation as one of the main non-pharmacological resources of preventive and therapeutic action. Objectives: To verify the effect of a semi-supervised home-based physical exercise program on sleep quality in a sedentary elderly population, which influences the improvement of self-reported sleep quality and the reduction of excessive daytime sleepiness in a sedentary elderly population. Methods: This protocol study of randomized, controlled, blinded clinical trial was designed, is being conducted and will be reported according to the guidelines of the CONSORT (Consolidated Standards of Reporting Trials) Statement, and is being conducted from July 2016 to December 2017, involving elderly people of both sexes, over 60 years old, living in Senhor do Bonfim. The home physical exercise program is based on the recommendations of the American College of Sports Medicine for exercise and physical activity for the elderly. Results: The first expected outcome is the improvement of self-reported sleep quality verified through the PSQI. The secondary outcomes are reduction in excessive daytime sleepiness among the sedentary elderly subjects undergoing the semi-supervised home-based physical exercise program, verified by the ESS, and the adherence of the subjects to the program. Conclusions: We hope that through this study, we can show that the regular practice of semi-supervised home exercises is effective in improving sleep quality and reducing excessive daytime sleepiness in sedentary elderly people and can be considered as a therapeutic, safe, easy-to-implement, and low-cost non-pharmacological resource.

Aerobic exercise modulates cytokine profile and sleep quality in elderly.

Sleep disturbance is a major problem for older adults which can be exacerbated by increased inflammation as aging is associated with increased circulating pro-inflammatory and lower anti-inflammatory cytokines. There is a need to develop alternative medicine techniques to help improve sleep quality in the elderly. To investigate the effects of aerobic exercise training on the sleep quality and inflammatory cytokines in elderly subjects. Forty previously sedentary elderly subjects participated in this study, their age ranged from 61- 67 years. All subjects were randomly assigned to supervised aerobic exercise intervention group (group A, n=25) or control group (group B, n=25). Polysomnographic recordings for sleep quality assessment, interleukin- 6 (IL-6), tumor necrosis factor- alpha (TNF-α) and interleukin-10 (IL-10) were measured before and after 6 months at the end of the study. There was a significant increase in total sleep duration, sleep efficiency and sleep onset latency in group(A) after 6 months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after 6 months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of TNF- α and IL-6 decreased significantly and the mean value of IL-10 significantly increased in group (A) after the aerobic exercise training, however the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study. Exercise training can be considered as a non-pharmacological modality for modifying sleep quality and inflammation among elderly.

Mobilidade funcional, força, medo de cair, estilo e qualidade de vida em idosos praticantes de caminhada

O processo de envelhecimento envolve modificações no desempenho locomotor que podem predispor os idosos a quedas e alterações na qualidade de vida. Objetivo: Comparar o medo de cair, mobilidade funcional, força de membros inferiores, estilo e qualidade de vida em idosos sedentários e praticantes caminhada. Método: Trata-se de estudo transversal observacional do qual participaram 51 idosos, 25 praticantes de caminhada (GCam) e 26 sedentários (GSed), submetidos à avaliação de mobilidade funcional (Timed Up and Go - TUG), da força de membros inferiores (teste senta-levanta), medo de cair (Escala Internacional de Eficácia de Quedas - FES-I), estilo de vida (questionário FANTASTICO) e Qualidade de vida (SF-36). Resultados: Não houve diferença entre os grupos em relação às médias de idade, distribuição de gênero e índice de massa corporal. Os participantes do GCam apresentaram mobilidade funcional significantemente melhor (9,45±2,68 vs. 14,97±6,55 segundos; p=0,001) que os do GSed, e menos medo de cair (23,16±5,33 vs. 29,04±10,22; p=0,01). O estilo de vida também foi superior entre os praticantes de caminhada (79,84±5,52 vs. 67,19±10,35; (p=0,0001). Em relação à qualidade de vida, o GCam apresentou escores maiores nos domínios capacidade funcional (p=0,013), limitações por aspecto físico (p=0,17) e limitações por aspectos emocionais (p=0,05). Já no domínio dor, o GCam apresentou pior resultado (p=0,05) em relação ao GSed. Conclusão: Idosos praticantes regulares de caminhada possuem melhor resultados em relação à mobilidade funcional, habilidade de levantar e sentar, menos medo de cair, melhor estilo de vida e alguns domínios da qualidade de vida do que idosos sedentários.

Inspiratory muscle performance in endurance-trained elderly males during incremental exercise

The aim of this study was to compare the inspiratory muscle performance during an incremental exercise of twelve fit old endurance-trained athletes (OT) with that of fit young athletes (YT) and healthy age-matched controls (OC). The tension-time index (TT0.1) was determined according to the equation TT0.1=P0.1/PImax×ti/ttot, where P0.1 is the mouth occlusion pressure, PImax the maximal inspiratory pressure and ti/ttot the duty cycle. For a given VCO2, OT group displayed P0.1, P0.1/PImax ratio, TT0.1 and effective impedance of the respiratory muscle values which were lower than OC group and higher than YT group. At maximal exercise, P0.1/PImax ratio and TT0.1 was still lower in the OT group than OC group and higher than YT group. This study showed lower inspiratory muscle performance attested by a higher (TT0.1) during exercise in the OT group than YT group, but appeared to be less marked in elderly men having performed lifelong endurance training compared with sedentary elderly subjects.

Left ventricular atrioventricular plane displacement is preserved with lifelong endurance training and is the main determinant of maximal cardiac output.

Age-related decline in cardiac function can be prevented or postponed by lifelong endurance training. However, effects of normal ageing as well as of lifelong endurance exercise on longitudinal and radial contribution to stroke volume are unknown. The aim of this study was to determine resting longitudinal and radial pumping in elderly athletes, sedentary elderly and young sedentary subjects. Furthermore, we aimed to investigate determinants of maximal cardiac output in elderly. Eight elderly athletes (63 ± 4 years), seven elderly sedentary (66 ± 4 years) and ten young sedentary subjects (29 ± 4 years) underwent cardiac magnetic resonance imaging. All subjects underwent maximal exercise testing and for elderly subjects maximal cardiac output during cycling was determined using a dye dilution technique. Longitudinal and radial contribution to stroke volume did not differ between groups (longitudinal left ventricle (LV) 52-65%, P = 0.12, right ventricle (RV) 77-87%, P = 0.16, radial 7.9-8.6%, P = 1.0). Left ventricular atrioventricular plane displacement (LVAVPD) was higher in elderly athletes and young sedentary compared with elderly sedentary subjects (14 ± 3, 15 ± 2 and 11 ± 1 mm, respectively, P < 0.05). There was no difference between groups for RVAVPD (P = 0.2). LVAVPD was an independent predictor of maximal cardiac output (R(2) = 0.61, P < 0.01, β = 0.78). Longitudinal and radial contributions to stroke volume did not differ between groups. However, how longitudinal pumping was achieved differed; elderly athletes and young sedentary subjects showed similar AVPD whereas this was significantly lower in elderly sedentary subjects. Elderly sedentary subjects achieved longitudinal pumping through increased short-axis area of the ventricle. Large AVPD was a determinant of maximal cardiac output and exercise capacity.

Mitochondria association to Calcium Release Units is controlled by age and muscle activity

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Flexibility of the Elderly after One-Year Practice of Yoga and Calisthenics

Flexibility training responses to distinct stretching techniques are not well defined, especially in the elderly. This study compared the flexibility of elderly individuals before and after having practiced hatha yoga and calisthenics for 1 year (52 weeks), at least 3 times/week. Sixty-six subjects (12 men) measured and assigned to 3 groups: control (n = 24, age = 67.7±6.9 years), hatha yoga (n = 22, age = 61.2±4.8 years), and calisthenics (n = 20, age = 69.0±5.8 years). The maximal range of passive motion of 13 movements in 7 joints was assessed by the Flexitest, comparing the range obtained with standard charts representing each arc of movement on a discontinuous and non-dimensional scale from 0 to 4. Results of individual movements were summed to define 4 indexes (ankle+knee, hip+trunk, wrist+elbow, and shoulder) and total flexibility (Flexindex). Results showed significant increases of total flexibility in the hatha yoga group (by 22.5 points) and the calisthenics group (by 5.8 points) (p < 0.01 for each) and a decrease in the control group (by 2.1 points) (p < 0.01) after one year of intervention. Between-group comparison showed that increases in the hatha yoga group were greater than in the calisthenics group for most flexibility indexes, particularly the overall flexibility (p <0.05). In conclusion, the practice of hatha yoga (i.e., slow/passive movements) was more effective in improving flexibility compared to calisthenics (i.e., fast/dynamic movements), but calisthenics was able to prevent flexibility losses observed in sedentary elderly subjects.

Effect of physical activity on heart rate variability and carotid intima-media thickness in older people

We investigated the effect of physical activity on heart rate variability (HRV) and carotid intima-media thickness (IMT) in elderly subjects and the relationship between HRV and IMT. Thirty-two elderly sedentary subjects and 32 age-matched endurance athletes underwent ultrasonography of the carotid wall for measuring IMT, and 24-h ECG monitoring for measuring HRV. Elderly athletes had evidence of increased vagal activity in the time (SDANN, rMSSD, and pNN50; p < 0.01) and frequency domain (HF and LF/HF ratio, p < 0.01) with respect to sedentary subjects. Moreover, athletes showed lower IMT than control subjects (p < 0.01). In the whole population SDNN was inversely related to IMT, respectively (r = -0.60 and r = -0.58, p < 0.0001), while LF/HF ratio related positively to IMT. In conclusion, this study demonstrated that in aging HRV is negatively associated with IMT, a putative index of atherosclerosis, confirming cardiac autonomic neuropathy as part of the pathophysiological pathway for atherosclerosis. It confirms that the regular physical activity represents a valuable strategy to counter age-related impairments of cardiac autonomic activity and artery structural changes.

Skeletal muscle mitochondrial dysfunction during chronic obstructive pulmonary disease: central actor and therapeutic target

Muscle dysfunction is a common complication and an important prognostic factor in chronic obstructive pulmonary disease (COPD). As therapeutic strategies are still needed to treat this complication, gaining more insight into the process that leads to skeletal muscle decline in COPD appears to be an important issue. This review focuses on mitochondrial involvement in limb skeletal muscle alterations (decreased muscle mass, strength, endurance and power and increased fatigue) in COPD. Mitochondria are the main source of energy for the cells; they are involved in production of reactive oxygen species and activate an important pathway that leads to apoptosis. In COPD patients, skeletal muscles are characterized by decreased mitochondrial density and biogenesis, impaired activity and coupling of mitochondrial respiratory chain complexes, increased mitochondrial production of reactive oxygen species and, possibly, increased apoptosis. Of particular interest, a sedentary lifestyle, hypoxia, hypercapnia, tobacco smoking, corticosteroid therapy and, possibly, inflammation participate in this mitochondrial dysfunction, which is accessible to conventional therapies, such as exercise and tobacco cessation, as well as, potentially, to more innovative approaches, such as antioxidant treatment and supplementation with polyunsaturated fatty acids.

Skeletal muscle insulin resistance promotes increased hepatic de novo lipogenesis, hyperlipidemia, and hepatic steatosis in the elderly.

Aging is closely associated with muscle insulin resistance, hyperlipidemia, nonalcoholic fatty liver disease (NAFLD), and type 2 diabetes. We examined the hypothesis that muscle insulin resistance in healthy aging promotes increased hepatic de novo lipogenesis (DNL) and hyperlipidemia by altering the distribution pattern of postprandial energy storage. Healthy, normal weight, sedentary elderly subjects pair-matched to young subjects were given two high-carbohydrate meals followed by 13C/1H magnetic resonance spectroscopy measurements of postprandial changes in muscle and liver glycogen and lipid content, and assessment of DNL using 2H2O. Net muscle glycogen synthesis was reduced by 45% (P < 0.007) in the elderly subjects compared with the young, reflecting severe muscle insulin resistance. Net liver glycogen synthesis was similar between groups (elderly, 143 ± 23 mmol/L vs. young, 138 ± 13 mmol/L; P = NS). Hepatic DNL was more than twofold higher in the elderly than in the young subjects (elderly, 14.5 ± 1.4% vs. young, 6.9 ± 0.7%; P = 0.00015) and was associated with approximately threefold higher postprandial hepatic triglyceride (TG) content (P < 0.005) and increased fasting plasma TGs (elderly, 1.19 ± 0.18 mmol/L vs. young, 0.74 ± 0.11 mmol/L; P = 0.02). These results strongly support the hypothesis that muscle insulin resistance in aging promotes hyperlipidemia and NAFLD by altering the pattern of postprandial carbohydrate storage away from muscle glycogen and into hepatic DNL.

The effect of ballroom dance on balance and functional autonomy among the isolated elderly

The aim of the present study was to analyze the influence of a ballroom dancing program on the functional autonomy and physical balance of institutionalized elderly individuals. The study enrolled 75 sedentary elderly subjects from long-term institutions who were randomly divided into a ballroom dance program group (EG; n=39) and a control group (CG; n=36). The protocol of the Latin American Group for Maturity (GDLAM) was used to evaluate functional autonomy. Physical balance was analyzed using a stabilometer and posture meter platforms. The level of significance in statistical tests was set at p<0.05. Regarding the physical balance evaluation, only the members of the EG achieved a significant reduction in weight (Δ=−0.98kg) following the experiment, both in the intragroup (p=0.002) and in the intergroup analysis (p=0.012). In the evaluation of functional autonomy, only the EG showed a significant reduction in the execution time of all the tests and in the GDLAM index: GI (Δ=−6.99), both in the intragroup (p<0.001) and in the intergroup analysis (p=0.011). Thus, it can be inferred that sedentary elderly individuals who are residents of long-term institutions can improve their functional autonomy and balance with a ballroom dance program.

Ectopic Lipid Accumulation and Reduced Glucose Tolerance in Elderly Adults Are Accompanied by Altered Skeletal Muscle Mitochondrial Activity

Aging is associated with insulin resistance and unfavorable changes in body composition including increased fat accumulation, particularly in visceral and ectopic depots. Recent studies suggest that skeletal muscle mitochondrial activity may underlie some age-associated metabolic abnormalities. Our objective was to measure mitochondrial capacity and coupling of the vastus lateralis muscle in elderly and young adults using novel in vivo approaches and relate mitochondrial activity to metabolic characteristics. This was a cross-sectional study. Fourteen sedentary young (seven males and seven females, 20-34 yr of age) and 15 sedentary elderly (seven males and eight females, 70-84 yr of age) nonobese subjects selected for similar body weight underwent measures of body composition by magnetic resonance imaging and dual-energy x-ray absorptiometry, oral glucose tolerance, and in vivo mitochondrial activity by (31)P magnetic resonance and optical spectroscopy. Muscle biopsy was carried out in the same muscle to measure mitochondrial content, antioxidant activity, fiber type, and markers of mitochondrial biogenesis. Elderly volunteers had reduced mitochondrial capacity (P = 0.05) and a trend for decreased coupling efficiency (P = 0.08) despite similar mitochondrial content and fiber type distribution. This was accompanied by greater whole-body oxidative stress (P = 0.007), less skeletal muscle mass (P < 0.001), more adipose tissue in all depots (P ≤ 0.002) except intramyocellular (P = 0.72), and lower glucose tolerance (P = 0.07). Elderly adults show evidence of altered mitochondrial activity along with increased adiposity, oxidative stress, and reduced glucose tolerance, independent of obesity. We propose that mild uncoupling may be induced secondary to age-associated oxidative stress as a mechanism to dissipate the proton-motive force and protect against further reactive oxygen species production and damage.

Effects of age, gender and physical activity on plasma lipid profile

Effects of age, gender and physical activity on plasma lipid profile Study aim: To assess the effects of gender, age and engagement in physical activities of elderly subjects on their plasma lipid profiles. Material and methods: Four groups of subjects, n = 11 each, participated in the study: young men (YM) and women (YW), aged 25 - 32 years, and sedentary, elderly men (EM) and women (EW), aged 58 - 66 years; additionally, a group of 7 women (AW), aged 60 - 65 years, who trained twice weekly (45-min sessions) for 8 months, was studied. The following concentrations of lipids in plasma were recorded: triacylglycerols (TG), total cholesterol (TC) and its fractions: HDLC and LDLC (computed), as well as the TC/HDLC ratio. Results: Lipid profiles were, generally, less favourable in elderly than in younger subjects, high HDLC values noted in active, elderly women being an exception. In elderly subjects, men's profiles were closer to those of younger subjects than in elderly women and differed significantly (p&lt;0.001) lower for TC and LDLC compared with EW group. Triacylglycerols were within normal limits in all groups except EW; LDLC values were mostly abnormally high, the percentages of subjects having normal values ranging from 0 (YM and EW) to 27% (YW). Conclusions: The age-dependent worsening of lipid profiles increased the risk of cardiovascular diseases in sedentary elderly subjects. On the other hand, the beneficial effects of motor activities on lipid profile observed in elderly women evidence the indispensability recommending of physical exercises to the elderly.

Correlation between two physical activity programs in the gait of sedentary elderly subjects.

To assess the effect of exercise on gait using two different programs: a group of aerobic exercises (Group A, n = 18) and a group of flexibility and balance exercises (Group B, n = 19). A casualized controlled study, in which each sample controlled itself, was undertaken. The sample comprised 37 male and female subjects, aged from 60 to 90 years, from the outpatient clinic of the Geriatrics Unit of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo; the patients were sedentary and had not exercised regularly during the past six months. Improvement of gait was seen mainly in the group that did specific exercises. The results of this study underline the importance of physical exercises in sedentary elderly subjects, but show the need for programming the exercises towards specific goals, which can optimize the results of this tool of health promotion for the elderly.

Use of Accelerometry to Quantify the Physical Activity Level of the Elderly

This study investigated the reliability and validity of using an accelerometry system to quantify the physical activity level of Chinese elderly subjects. Thirty-eight volunteers wore an accelerometer for 3 days. Test–retest reliability, the sensitivity of the measurements, and the correlation between the results and the results of a commonly used physical activity questionnaire were measured. The accelerometry system was found to be reliable (intraclass correlation coefficient, 0.978). The system was able to differentiate young adults and active elderly from sedentary elderly subjects ( p < 0.001). The results showed a moderate but significant correlation with scores on the questionnaire ( r = 0.830; p < 0.001). The accelerometry system can be used as an objective tool to quantify the physical activity level of the elderly, specifically Chinese subjects.

Effect of Acute and Long-Term Aerobic Exercise on Arterial Stiffness in the Elderly

Arterial stiffness is an important factor for cardiovascular performance and a predictor of cardiovascular risk. We evaluated the effects of both acute and long-term aerobic exercise on arterial stiffness in community-dwelling healthy elderly subjects. In addition, we evaluated the relationship between the effects of long-term exercise and those of acute exercise. The study subjects were participants in the Shimanami Health Promoting Program study (J-SHIPP), which was designed to investigate factors relating to cardiovascular disease, dementia, and death (67+/-6 years). They performed mild-to-moderate aerobic exercise lasting for 30 min twice a week for 6 months. Arterial stiffness was assessed before and after the first 30-min acute exercise (n=99) and long-term 6-month aerobic training (n=40). The radial arterial augmentation index (AI) obtained from the radial pulse waveform by the tonometry method was used as a parameter of arterial stiffness. Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly decreased after 30-min of aerobic exercise, however no significant change in AI was observed. On the other hand, there were significant decreases in AI (from 87 to 84%, p<0.01), SBP (from 136 to 129 mmHg, p<0.01), and DBP (from 75 to 70 mmHg, p<0.01) after the 6-month exercise period. Long-term exercise-induced changes in AI were significantly and inversely correlated with the pre-exercise AI (r=-0.40, p<0.01). In addition, AI changes after the 6-month exercise period were significantly related to those observed after first 30-min exercise (r=0.48, p<0.01). These findings indicate that apparently healthy and sedentary elderly subjects with higher AI may benefit from mild-to-moderate aerobic exercise to improve arterial stiffness.

Carnosine, taurine and enzyme activities of human skeletal muscle fibres from elderly subjects with osteoarthritis and young moderately active subjects

Ageing is associated with a reduction in muscle carnosine (beta-alanyl-L-histidine), but there are no data on the changes specifically in type I and type II muscle fibres. Given the higher carnosine content of type II fibers, changes observed in whole muscle may be secondary to a shift in fibre composition. Carnosine, beta-alanine, histidine, taurine, and citrate synthase (CS) and glycogen phosphorylase (Phos), were measured in pools of single muscle fibres from freeze-dried muscle biopsies of vastus lateralis of nine elderly sedentary subjects (65-80 years) with osteoarthritis of the knee and undergoing total knee replacement, and nine young moderately active healthy subjects (20-35 years). Fibres were characterised as type I or II by myosin ATPase activity. Carnosine was 53.2% lower in type II fibres of older subjects resulting in an estimated 7% (and most probably still higher) decline in intracellular physico-chemical buffering capacity. Younger subjects showed higher CS activities in type I and higher Phos activities in type II fibres. These differences were less apparent in elderly subjects. Possible causes for the change in the carnosine content are reduced physical activity, reduced meat intake, or the result of progressive denervation.

The effects of long-term endurance training on the immune and endocrine systems of elderly men: the role of cytokines and anabolic hormones

Backgrounda decline in immune and endocrine function occurs with aging. The main purpose of this study was to investigate the impact of long-term endurance training on the immune and endocrine system of elderly men. The possible interaction between these systems was also analysed.Resultselderly runners showed a significantly higher T cell proliferative response and IL-2 production than sedentary elderly controls. IL-2 production was similar to that in young adults. Their serum IL-6 levels were significantly lower than their sedentary peers. They also showed significantly lower IL-3 production in comparison to sedentary elderly subjects but similar to the youngs. Anabolic hormone levels did not differ between elderly groups and no clear correlation was found between hormones and cytokine levels.Conclusionhighly conditioned elderly men seem to have relatively better preserved immune system than the sedentary elderly men. Long-term endurance training has the potential to decelerate the age-related decline in immune function but not the deterioration in endocrine function.

Ambulatory blood pressure monitoring and endothelium-dependent vasodilation in the elderly athletes

Aim Regular exercise is a key component of cardiovascular risk prevention strategies, because it is associated with a variety of beneficial metabolic and vascular effects that reduce mortality and the incidence of cardiovascular adverse events. Endothelium plays an important role in the local regulation of vascular tone and structure, mainly by nitric oxide (NO) synthesis and action. Aim of the present study was to evaluate in elderly athletes the effect of regular aerobic exercise on arterial blood pressure (BP) and on endothelium-dependent flow-mediated dilation (FMD) of the brachial artery. Methods The study population included 30 male subjects (mean age 65.6 ± 5.6 years), who had practiced endurance running at a competitive level for at least 40 years, and 28 age- and sex-matched subjects (mean age 64.5 ± 4.5 years) with sedentary lifestyle and free of cardiovascular disease. Athletes and control subjects underwent standard 12-lead ECG, clinic BP, 24-h ambulatory BP monitoring and endothelium-dependent FMD and endothelium-independent response to glyceryl trinitrate (GTN), 400 microg, in the brachial artery by high-resolution ultrasonography. Results Systolic clinic and ambulatory 24-h BP were significantly lower in the athletes, than in the controls ( P < 0.001, respectively). Systolic and diastolic 24-h BP variability, when assessed either by the standard deviation (S.D.), or by the coefficient of variation (CV), were also significantly lower in the athletes ( P < 0.01). The athletes also had a lower 24-h, day-time and night-time heart rate (HR) ( P < 0.01), as well as a lower HR variability ( P < 0.01). As regards circadian BP change, the %Δ was statistically significant greater in athletes ( P < 0.05). Elderly athletes showed higher FMD than elderly sedentary subjects ( P < 0.001), whereas no differences were shown in the response to GTN. Conclusions Our results, suggest that long-term physical activity can counteract the age-related endothelial dysfunction that characterizes sedentary aging, preserving the capacity of the endothelium-dependent vasodilation and reduces BP values improving arterial pressure control.