Acute Effects Of Sauna Exposure Compared To Aerobic Exercise On Pulse Wave Velocity

BackgroundStroke is a highly disabling condition and is the second leading cause of death globally. Engaging in aerobic exercise is important for the prevention of a recurrent stroke through improving markers of cardiovascular health such as blood pressure and arterial stiffness. While higher intensities of aerobic exercise generally elicit greater cardioprotective effects, little is known about the acute cardiovascular effects of a single session of high intensity aerobic exercise in people with stroke. The objective of this study was to model the recovery of arterial stiffness (carotid-femoral pulse wave velocity, cfPWV), heart rate and blood pressure following peak intensity aerobic exercise in individuals with chronic stroke.MethodsTen participants with chronic stroke (mean ± SD age = 56.9 ± 11.8 years, median [IQR] years post-stroke = 2.9 [1.9]) performed a symptom-limited cardiopulmonary exercise test (CPET) on a recumbent stepper. Before the CPET, resting cfPWV, heart rate and blood pressure were measured. Immediately following the CPET, all outcomes were measured again continuously for 20 min to use all available observations (n = 245 observations) and capture any potential non-linear changes. Mixed model analyses were then applied to model post-exercise changes of cfPWV, heart rate and blood pressure.ResultsCarotid-femoral pulse wave velocity was increased from rest following the CPET (9.0 ± 0.53 to 9.9 ± 0.52 m/s, p < 0.001) and remained elevated for 20 min into post-exercise recovery, independent of heart rate (p = 0.001). Heart rate also increased from baseline (71.2 ± 3.2 to 77.4 ± 3.1 bpm, p < 0.001) and remained elevated for 10 min post-exercise (p < 0.001). Finger systolic blood pressure was reduced from rest (117.3 ± 4.7 to 111.8 ± 4.6 mmHg, p < 0.001) and remained reduced for 15 min after exercise (p < 0.001). There were no significant differences in finger diastolic or mean arterial pressures from rest.ConclusionThis was the first study to capture continuous changes in cfPWV following peak aerobic exercise in any clinical population. The present study revealed that cfPWV is elevated for 20 min after peak aerobic exercise in individuals with stroke, which was independent of heart rate. These findings suggest there may be autonomic imbalances in large arteries following peak intensity aerobic exercise in individuals with stroke.

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Abstract P525: The Effect of Weight Loss Combined With Aerobic Exercise Training on Arterial Stiffness: Results From the PREVAIL Pilot Study

Circulation ◽

10.1161/circ.141.suppl_1.p525 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Damon L Swift ◽

Joshua E McGee ◽

Marie C Clunan ◽

Anna C Huff ◽

Briceida G Osborne ◽

...

Keyword(s):

Blood Pressure ◽

Weight Loss ◽

Exercise Training ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Aerobic Exercise ◽

Wave Velocity ◽

Pulse Wave ◽

Augmentation Index ◽

Aerobic Exercise Training

Objective: The OPTIFAST diet has known effects for weight loss, but little data exists on the effects of the diet on arterial stiffness. Methods: Overweight and obese (BMI: 34.5 + 4.0) adults (N=17) participated in a 10-week OPTIFAST™ weight loss program and supervised aerobic exercise training (50%-75% VO 2 max). The diet consisted of OPTIFAST meal replacement products with a goal of reducing total caloric intake to 800 kcals/day and attending a weekly weight management class. Aerobic exercise was performed 3 times per week and the exercise volume was progressed from 300 to 700 MET mins. per week at an intensity of 50%-75% VO2 max. The goal of study participants was to achieve a 7% weight loss. Carotid-to-femoral pulse wave velocity, blood pressure (aortic and brachial), vascular age, augmentation index and blood samples were measured in the morning after an overnight fast at baseline and follow-up. A paired t-test was performed to evaluate the change in outcomes variables. Results: The mean percent weight loss in the sample was 9.0% (-8.5 kg), with 83.3% of participants achieving 7% weight loss (94.1% achieving ≥5%). The adherence to the exercise program was 94.9% and attendance in the weight loss classes was 81.8%. There was a reduction in pulse wave velocity (-0.44 m/s, p=0.030), aortic systolic blood pressure (-10.5 mmHg, p<0.001), aortic diastolic blood pressure (-7.8 mmHg, p<0.001), brachial systolic blood pressure (-11.2 mmHg , p<0.001), brachial diastolic blood pressure (-7.7 mmHg, p<0.001), vascular age (-13.4 yrs., p=0.008), resting heart rate (-4.7 bpm, p=0.005), and augmentation index (-7.5%, p=0.008) after the intervention. Change in resting heart rate from the intervention was associated with improvements in augmentation index (r=0.60, p=0.010) and approached significance for pulse wave velocity (r=0.45, p=0.07). Weight loss was associated with reduction in augmentation index (r= 0.56, p=0.02), but not change in PWV (r=-0.07, p=0.78). Changes in other cardiometabolic risk factors (e.g. glucose, insulin, lipids, and body fat) were not associated with improvements in arterial stiffness or blood pressure measures (all ps>0.05). Discussion: A hypo-caloric dietary program in combination with aerobic exercise training improves arterial stiffness, aortic blood pressure, and brachial blood pressure in overweight and obese adults An important limitation of the present study is that we cannot separate the health benefits of the diet from the exercise.

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