Arterial stiffness and age moderate the association between physical activity and global cognition in the older adults

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Merck Sharp & Dohme Corp Program of the Faculty of Medicine of the Université de Montréal The Canadian Institutes of Health Research (CIHR) Background The growing concern on the impact of higher arterial stiffness on cognitive decline in older adults, leads to the question of whether non-pharmacological interventions like physical activity should be introduced to correct or diminish the progression of arterial stiffness. Purpose The goal of this study is to elaborate a model for arterial stiffness as a moderator for the physical activity and global cognition relationship in function of age. Methods One hundred ten healthy older adults aged 60 to 75 years old (46 men and 64 women) were examined for arterial stiffness (carotid-femoral Pulse Wave Velocity (cf-PWV)), global cognition (Montreal Cognitive Assessment and Mini Mental State Examination) and self-reported physical activity (PACED diary). The double moderation analysis used PROCESS macro for SPSS, where physical activity was included as the independent variable (X), global cognition as the dependent variable (Y), arterial stiffness as moderator 1 (W), and age moderator 2 (Z). This study used a cf-PWV cutoff of 8.5 m/s to identify micro-structural damage in the brain related to arterial stiffness. Results Results found that the arterial stiffness x age interaction moderated the effect of physical activity on global cognition (β = -.89, SE = .42, p = .037) (Model: R2 = .15, p = .018). Physical activity had a positive effect on cognition in younger-older adults (aged 60 to 68.5 years) with high arterial stiffness i.e. cf-PWV > 8.5 m/s (β = .57, SE = .222, p = .011, 95% CI .133 to 1.014), and in older-older adults (aged 68.6 to 75 years) with low arterial stiffness i.e. cf-PWV < 8.5 m/s (β = .49, SE = .190, p = .010, 95% CI = .116 to .869). Conclusions These results support targeted physical activity interventions based on age and degree of arterial stiffness, furthering the notion that even daily life physical activity could play an important role in older adults’ cognitive performances. Physical activity on global cognition Conditional effects of physical activity on global cognition Moderators cf-PWV Age Effect SE p CI < 8.5 m/s < 68.5 years .171 .245 .487 -.315 to .657 < 8.5 m/s > = 68.5 years .574 .222 .011* .133 to 1.014 > = 8.5 m/s < 68.5 years .492 .190 .010* .116 to .868 > = 8.5 m/s > = 68.5 years .002 .180 .990 -.355 to .359 Physical activity conditional effects on global cognition at determined values of arterial stiffness and age. SE: Standard Error, CI: Confidence Interval, cf-PWV: carotid-femoral Pulse Wave Velocity, *p-value<.05.

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Abstract P048: Segment-Specific Pulse Wave Velocity and Subclinical Cardiac Overload and Damage in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.137.suppl_1.p048 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Shuiqing Liu ◽

Esther Kim ◽

Aozhou Wu ◽

Michelle L Meyer ◽

Susan Cheng ◽

...

Keyword(s):

Older Adults ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Cardiac Disease ◽

Pulse Wave ◽

Troponin T ◽

High Sensitivity ◽

Clinical History ◽

Cardiac Biomarkers

Background: Pulse wave velocity (PWV) independently predicts cardiovascular disease. However, few studies simultaneously explored the associations of segment-specific PWV measures with markers of both cardiac overload (natriuretic peptide [NT-proBNP]) and damage (high-sensitivity cardiac troponin T [hs-cTnT]) among adults without cardiac disease. Methods: We examined 2,845 whites and blacks (67-90 years) without clinical history of cardiac disease during ARIC visit 5 (2011-13). The association of PWV quartiles (cf [carotid-femoral], hc [heart-carotid], hf [heart-femoral], ha [heart-ankle], ba [brachial-ankle], and fa [femoral-ankle]) with log-transformed NT-proBNP and hs-cTnT was evaluated using linear and logistic regression models to adjust for potential confounders. Results: Most PWV measures demonstrated J- or U-shaped associations with NTpro-BNP and hs-cTnT [Figure]. The highest vs. the second lowest quartile of central PWV measures (cfPWV, hfPWV, and hcPWV) was associated with higher levels of NT-proBNP independently of demographic characteristics. The associations were weaker for hs-cTnT. These associations were attenuated after further adjustment, but hcPWV and NT-proBNP remained borderline significant (p=0.069). haPWV, baPWV, and faPWV including peripheral elements had less evident positive associations after adjusting for traditional risk. Conclusion: The positive associations between PWV and cardiac biomarkers were stronger for central vs. peripheral arterial stiffness and for NT-proBNP vs. hs-cTnT among older adults without prevalent cardiac disease. Our findings indicate the relative importance of central arterial stiffness behind subclinical cardiac overload.

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Abstract P336: Diabetes and Impaired Fasting Glucose are Associated with Pulse Wave Velocity in Older Adults: the ARIC Study

Circulation ◽

10.1161/circ.129.suppl_1.p336 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Laura R Loehr ◽

Michelle Snyder ◽

Elizabeth Selvin ◽

Priya Palta ◽

James Pankow ◽

...

Keyword(s):

Older Adults ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Impaired Fasting Glucose ◽

Path Length ◽

Pulse Wave ◽

Fasting Glucose ◽

Cross Sectional ◽

Aric Study

Introduction: Arterial stiffness measured by pulse wave velocity (PWV) predicts cardiovascular disease and mortality. Diabetes and impaired fasting glucose (IFG) have been related to arterial stiffness in smaller studies. We assessed whether diabetes and impaired fasting glucose are associated with greater arterial stiffness measured by PWV in older adults, and to evaluate gender as a modifier. Methods: PWV data on 5,147 men and women with mean age of 75.5 years (range 66-90) examined in 2011-2013 by the Atherosclerosis Risk in Communities (ARIC) study were analyzed. Diabetes was defined as fasting glucose >126 mg/dl or on hypoglycemic agents and IFG as non-diabetics with fasting glucose 100-125 mg/dl. Technicians measured carotid-femoral (cfPWV) and brachial-ankle (baPWV) velocities at least twice using the Omron VP-1000 plus system (Colin Co., Ltd., Komaki, Japan). The mean of the last two available measurements was used. The path length for cfPWV was calculated by: path length (cm) = carotid to femoral distance (cm) - (suprasternal notch - carotid distance (cm)). Path length for baPWV was automatically calculated using height-based formulas. Multivariable linear regression was used to model the cross-sectional association between diabetes status and PWV. The multivariable association of age categories with PWV was evaluated for comparison to the effect size of diabetes. Results: Participants were 57% female, 20% African-American, and 73% hypertensive. Among them 1,354 had diabetes (26%) and 2,295 (45%) had impaired fasting glucose. After adjustment for age, race-center, gender, heart rate, hypertension, BMI, and smoking status (current, former and never), cfPWV was 87 cm/s higher on average for those with diabetes, and 21 cm/s higher for those with IFG, as compared to those free of diabetes or IFG. In comparison, a 4 year increase in age (after multivariable adjustment) was associated with 64 cm/s higher cfPWV among non-smokers without diabetes. Estimates for baPWV were smaller than those for cfPWV but showed a similar pattern. There was no significant interaction by gender (P >0.1). Conclusion: Diabetes and impaired fasting glucose are both associated with arterial stiffness in older adults. We estimate that the magnitude of the cross-sectional effect of diabetes on arterial stiffness is equivalent to 4 years of arterial aging.

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Different Relationship Between Physical Activity, Arterial Stiffness, and Metabolic Status in Obese Subjects

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0595 ◽

2017 ◽

Vol 14 (9) ◽

pp. 716-725 ◽

Cited By ~ 3

Author(s):

Hyung Joon Joo ◽

Sang-A Cho ◽

Jae-Young Cho ◽

Seunghun Lee ◽

Jae Hyung Park ◽

...

Keyword(s):

Physical Activity ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Glucose Level ◽

Wave Velocity ◽

Pulse Wave ◽

Vigorous Physical Activity ◽

Metabolic Status ◽

Activity Levels ◽

Obese Subjects

Background:Although the relationship between physical activity and arterial stiffness has been shown in healthy persons, it remains controversial in obese persons.Methods:From January 2014 to September 2014, we evaluated 795 obese subjects from 25 public health centers in Seoul, Korea. We compared physical activity and brachial-ankle pulse wave velocity (baPWV) between obese subjects with metabolic syndrome (MetS) (MO) and obese subjects without MetS (NMO).Results:The MO group had more men, higher body mass index (BMI), higher fasting glucose level, lower high-density lipoprotein-cholesterol level, and higher triglyceride level. The mean physical activity levels were similar between the 2 groups. baPWV was higher in the MO group than the NMO group. MO group showed positive correlation between baPWV and physical activity (Ptrend = 0.04). Interestingly, baPWV was significantly higher in the MO group than in the NMO group in subjects with moderate and vigorous physical activity (1403.4 cm/sec vs 1349 cm/sec [95% CI 21.4 to 87.4], P < .05). Multivariate regression analysis demonstrated that brachial-ankle pulse wave velocity was apparently associated with age, BMI, blood pressure, and glucose level.Conclusions:In a community-based population, baPWV was higher in obese MetS group compared with obese non-MetS group. Physical activity showed different association with baPWV depending on metabolic status.

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Short-Term Prognostic Impact of Arterial Stiffness in Older Adults Without Prevalent Cardiovascular Disease

Hypertension ◽

10.1161/hypertensionaha.119.13496 ◽

2019 ◽

Vol 74 (6) ◽

pp. 1373-1382 ◽

Cited By ~ 6

Author(s):

Esther D. Kim ◽

Shoshana H. Ballew ◽

Hirofumi Tanaka ◽

Gerardo Heiss ◽

Josef Coresh ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Older Adults ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Prognostic Impact ◽

Bottom Quartile ◽

All Cause Mortality

Arterial stiffness, represented as carotid-femoral pulse wave velocity (cfPWV), predicts cardiovascular disease (CVD). In older populations, however, this association seems attenuated. Moreover, the prognostic values of pulse wave velocity at different arterial segments and newer parameters like cardio-ankle vascular index (CAVI) remain unclear, especially in US older adults. In 3034 Atherosclerosis Risk in Communities (ARIC) study participants (66–90 years) without CVD, we examined the associations of 4 pulse wave velocity measures (cfPWV, heart-femoral, brachial-ankle, heart-ankle) and 2 new measures of arterial stiffness (CAVI and cardio-femoral vascular index derived from heart-ankle and heart-femoral, respectively) with incident CVD (coronary disease, stroke, and heart failure) and all-cause mortality. Over a median follow-up of 4.4 years, there were 168 incident CVD events and 244 deaths. Overall, stiffness measures did not show strong associations with CVD, except cfPWV, which demonstrated a J-shaped association even after adjusting for potential confounders (hazard ratio, 1.83 [95% CI, 1.08–3.09] in top quartile and 1.97 [1.14–3.39] in bottom quartile versus second bottom quartile). When each CVD was examined separately, heart failure was most robustly associated with higher cfPWV, and stroke was strongly associated with lower cfPWV. There were no significant associations with all-cause mortality. Among different measures of pulse wave velocity, cfPWV showed the strongest associations with CVD, especially heart failure, in older adults without CVD. Other pulse wave velocity measures had no strong associations. Our findings further support cfPWV as the index measure of arterial stiffness and the link of arterial stiffness to heart failure development but also suggest somewhat limited prognostic value of arterial stiffness in older adults overall.

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Impact of Hot Yoga on Arterial Stiffness and Quality of Life in Overweight/Obese Adults

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0170 ◽

2016 ◽

Vol 13 (12) ◽

pp. 1360-1363 ◽

Cited By ~ 11

Author(s):

Stacy D. Hunter ◽

Mandeep S. Dhindsa ◽

Emily Cunningham ◽

Takashi Tarumi ◽

Mohammed Alkatan ◽

...

Keyword(s):

Quality Of Life ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Well Being ◽

Normal Body Mass Index ◽

Obese Adults ◽

The Impact

Background:Obesity is associated with arterial stiffening and diminished quality of life. Bikram yoga may be a feasible alternative to traditional exercise among obese individuals. Accordingly, the purpose of this study was to investigate the impact of Bikram yoga, a heated style of hatha yoga, on arterial stiffness in normal and overweight/obese adults.Methods:Forty-three (23 normal body mass index or BMI; 20 overweight/obese) apparently healthy participants completed an 8-week Bikram yoga intervention. Body composition was estimated via dual energy x-ray absorptiometry, arterial stiffness was measured via brachialankle pulse wave velocity, and health-related quality of life was assessed via RAND 36-Item Short Form survey at baseline and at the end of the 8-week intervention.Results:After the intervention, brachial-ankle pulse wave velocity decreased (P < .05) in overweight/obese participants while no such changes were observed in normal BMI participants. In the quality of life measures, emotional well-being improved (P < .05) in both groups, and general health improved (P < .05) only in the normal weight BMI group.Conclusion:Bikram yoga ameliorates arterial stiffness in overweight/obese adults and can positively impact quality of life regardless of BMI.

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Elevated Aortic Pulse Wave Velocity, a Marker of Arterial Stiffness, Predicts Cardiovascular Events in Well-Functioning Older Adults

Circulation ◽

10.1161/circulationaha.104.483628 ◽

2005 ◽

Vol 111 (25) ◽

pp. 3384-3390 ◽

Cited By ~ 747

Author(s):

Kim Sutton-Tyrrell ◽

Samer S. Najjar ◽

Robert M. Boudreau ◽

Lakshmi Venkitachalam ◽

Varant Kupelian ◽

...

Keyword(s):

Older Adults ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Cardiovascular Events ◽

Pulse Wave ◽

Aortic Pulse Wave Velocity

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Association of the Amount and Pattern of Physical Activity With Arterial Stiffness: The Maastricht Study

Innovation in Aging ◽

10.1093/geroni/igaa057.2863 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 790-790

Author(s):

Evelien Vandercappellen ◽

Ronald Henry ◽

Coen Stehouwer ◽

Annemarie Koster

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Cvd Risk ◽

Intensity Physical Activity ◽

Activity Groups

Abstract We examined the associations of the amount and the pattern of higher intensity physical activity with arterial stiffness. Data from The Maastricht Study (n=1699; mean age: 60±8 years, 49.4% women, 26.9% type 2 diabetes (T2DM)) were used. Arterial stiffness was assessed by carotid-to-femoral pulse wave velocity (cfPWV). The amount (hours/day) and pattern of higher intensity physical activity were assessed with the activPAL3®. Activity groups were: inactive (<75min/week), insufficiently active (75-150min/week), weekend warrior (>150min/week in ≤2 sessions), and regularly active (>150min/week in ≥3 sessions). After full adjustment, higher intensity physical activity was associated with lower cfPWV (amount: -0.35[-0.65;-0.05], insufficiently active: -0.33[-0.55;-0.11]; weekend warrior: -0.38[-0.64;-0.12] and regularly active: -0.46[-0.71;-0.21] (reference: inactive)). These associations were stronger in those with T2DM. Participating in higher intensity physical activity was associated with lower cfPWV, regardless of the weekly pattern, and may be an important strategy to reduce CVD risk, particularly in T2DM.

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Abstract P132: Time Since Smoking Cessation and Pulse Wave Velocity: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.129.suppl_1.p132 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Ricky L Camplain ◽

Michelle L Snyder ◽

Priya Palta ◽

Hanyu Ni ◽

Kenneth R Butler ◽

...

Keyword(s):

Older Adults ◽

Smoking Cessation ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Smoking Status ◽

Former Smokers ◽

Never Smokers ◽

Aric Study

Cigarette smoking is a preventable cause of cardiovascular disease and is associated with arterial stiffening among young adults. While smoking cessation lowers the risk of cardiovascular morbidity and mortality, evidence for a relationship between time since smoking cessation and arterial stiffness is limited in older adults. We assessed the association of smoking status and time since smoking cessation with arterial stiffness, measured by carotid-femoral (cfPWV) and brachial-ankle (baPWV) pulse wave velocity, conditional on intensity and duration of exposure to smoking (pack-years). Analyses included 1,996 men and 2,767 women aged 67 to 90 years examined in the ARIC study in 2011-2013. Smoking status was ascertained at all five ARIC examinations and during annual telephone interviews. Information on age at initiation of smoking, smoking intensity and duration were also collected. Pack-years were calculated as the product of the average number of cigarettes smoked per day and years smoked divided by 20. Two measures of baPWV and cfPWV were obtained then averaged. Multivariable linear regression was used to estimate the association between smoking status and time since smoking cessation with PWV by gender, adjusted for age, hypertension, body mass index (BMI), and heart rate. Estimates of the association between smoking cessation and PWV were further adjusted for pack-years. Among women, former smokers and current smokers had a lower baPWV when compared to never smokers [β = -40.9 (95% confidence interval (CI): -64.2, -17.6) and β = -119.7 (95%CI: -168.7, -70.7), respectively]. Similar patterns were observed for cfPWV; however, the relationship was only significant among former smokers [β = -25.3 (95%CI: -48.0, -2.5)]. Association of smoking status and PWV was not significant in men. Among men who were former smokers there was a negative and significant association between smoking cessation and cfPWV [β = -1.4 (-2.7, -0.4)]; however, this same relationship was not observed for baPWV. BMI modified the association between smoking cessation and PWV in women. Time since smoking cessation was positively associated with PWV in women with a BMI <25 kg/m 2 [baPWV: β = 3.8 (95%CI: 1.2, 6.5); cfPWV: β = 2.5 (0.3, 4.7)], but not in women with a BMI ≥25 kg/m 2 . In these cross-sectional analyses, ever smokers had lower PWV compared to never smokers among older women, but not among older men. Greater time since smoking cessation was positively associated with arterial stiffness among normal or underweight women, but not among women who were overweight or obese, or among men. Accounting for cumulative exposure to smoking over the life course, gender-specific and arterial segment-specific patterns were observed in the association between time since smoking cessation and arterial stiffness measured in community-dwelling older adults, as well as a modification of these associations by excess weight among women.

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Association Between Physical Activity Intensity Levels and Arterial Stiffness in Healthy Children

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0594 ◽

2020 ◽

Vol 17 (10) ◽

pp. 933-939

Author(s):

Lisa Heil ◽

Renate Oberhoffer ◽

Birgit Böhm

Keyword(s):

Physical Activity ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Moderate Intensity ◽

Healthy Children ◽

Substantial Impact ◽

Activity Intensity ◽

Vigorous Intensity

Background: Physical activity (PA) has a substantial impact on arterial stiffness in adults; however, evidence regarding children is scarce. The aim of this study was to examine the association between objectively measured PA with different intensities and surrogate measures of arterial stiffness in healthy children. Methods: Altogether, 80 children (41 girls and 39 boys, ranging from 8–11 y) participated in this prospective, cross-sectional study. Sedentary time and PA of light, moderate, and vigorous intensity levels were measured over a period of 7 days by accelerometry. Arterial stiffness parameters, including pulse wave velocity and central systolic blood pressure (cSBP), were noninvasively assessed by the oscillometric Mobil-O-Graph. Associations were tested using multiple linear regressions with adjustments for potential confounders (α ≤ .05). Results: PA of moderate intensity was negatively associated with cSBP (β = −0.266, P = .017). PA of vigorous intensity was inversely related to pulse wave velocity (β = −0.225, P = .045) and cSBP (β = −0.286, P = .010), respectively. Conclusion: Higher time spent in PA of moderate and vigorous intensity is associated with reduced pulse wave velocity and lower cSBP values in children. It suggests that PA is a favorable determinant of arterial health.

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Association of the Amount and Pattern of Physical Activity With Arterial Stiffness: The Maastricht Study

Journal of the American Heart Association ◽

10.1161/jaha.120.017502 ◽

2020 ◽

Vol 9 (20) ◽

Author(s):

Evelien J. Vandercappellen ◽

Ronald M.A. Henry ◽

Hans H.C.M. Savelberg ◽

Julianne D. van der Berg ◽

Koen D. Reesink ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Intensity Physical Activity

Background Arterial stiffness is an independent risk factor for cardiovascular disease and can be beneficially influenced by physical activity. However, it is not clear how an individual’s physical activity pattern over a week is associated with arterial stiffness. Therefore, we examined the associations of the amount and pattern of higher intensity physical activity with arterial stiffness. Methods and Results Data from the Maastricht Study (n=1699; mean age: 60±8 years, 49.4% women, 26.9% type 2 diabetes mellitus) were used. Arterial stiffness was assessed by carotid‐to‐femoral pulse wave velocity and carotid distensibility. The amount (continuous variable as h/wk) and pattern (categorical variable) of higher intensity physical activity were assessed with the activPAL3. Activity groups were: inactive (<75 min/wk), insufficiently active (75–150 min/wk), weekend warrior (>150 min/wk in ≤2 sessions), and regularly active (>150 min/wk in ≥3 sessions). In the fully adjusted model (adjusted for demographic, lifestyle, and cardiovascular risk factors), higher intensity physical activity was associated with lower carotid‐to‐femoral pulse wave velocity (amount: β = −0.05, 95% CI, −0.09 to −0.01; insufficiently active: β = −0.33, 95% CI, −0.55 to −0.11; weekend warrior: β = −0.38, 95% CI, −0.64 to −0.12; and regularly active: β = −0.46, 95% CI, −0.71 to −0.21 [reference: inactive]). These associations were stronger in those with type 2 diabetes mellitus. There was no statistically significant association between higher intensity physical activity with carotid distensibility. Conclusions Participating in higher intensity physical activity was associated with lower carotid‐to‐femoral pulse wave velocity, but there was no difference between the regularly actives and the weekend warriors. From the perspective of arterial stiffness, engaging higher intensity physical activity, regardless of the weekly pattern, may be an important strategy to reduce the risk of cardiovascular disease, particularly in individuals with type 2 diabetes mellitus.

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