Relative importance of step count, intensity, and duration on physical activity's impact on vascular structure and function in previously sedentary older adults

J Am Heart Assoc. 2014 Feb 26;3(1):e000702. doi: 10.1161/JAHA.113.000702.

Abstract

Background: Age-related endothelial dysfunction and vascular stiffening are associated with increased cardiovascular (CV) risk. Many groups have encouraged goals of ≥10 000 steps/day or ≥30 min/day of moderate intensity physical activity (MPA) to reduce age-related CV risk. The impact of MPA on the vasculature of older adults remains unclear.

Methods and results: We randomized 114 sedentary older adults ages ≥50 to 12 weeks of either no intervention (group 1), a pedometer-only intervention (group 2), or a pedometer with an interactive website employing strategies to increase the adoption of habitual physical activity (PA, group 3). Endothelial function by brachial flow-mediated dilation (FMD%), vascular stiffness by tonometry, step-count by pedometer, and PA intensity/distribution by accelerometer were measured. Step-count increased in groups 2 (5136±1554 to 9596±3907, P<0.001) and 3 (5474±1512 to 8167±3111, P<0.001) but not in group 1 (4931±1667 to 5410±2410). Both groups 2 and 3 increased MPA ≥30 min/day. Only group 3 increased MPA in continuous bouts of ≥10 minutes (P<0.001) and improved FMD% (P=0.001). Neither achievement of ≥10 000 steps/day nor ≥30 min/day of MPA resulted in improved FMD%. However, achieving ≥20 min/day in MPA bouts resulted in improved FMD%. No changes in vascular stiffness were observed.

Conclusions: MPA reverses age-related endothelial dysfunction, but may require MPA to be performed in bouts of ≥10 minutes duration for ≥20 min/day to be effective. Commonly encouraged PA goals do not guarantee improved endothelial function and may not be as effective in reducing CV risk.

Clinical trial registration url: Clinicaltrials.gov. UNIQUE IDENTIFIER: NCT-01212978.

Trial registration: ClinicalTrials.gov NCT01212978.

Keywords: elderly; endothelial function; physical exercise.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Actigraphy
  • Age Factors
  • Aged
  • Aging*
  • Brachial Artery / physiopathology*
  • Endothelium, Vascular / physiopathology*
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Motor Activity*
  • Recovery of Function
  • Risk Factors
  • Risk Reduction Behavior*
  • Sedentary Behavior*
  • Time Factors
  • Vascular Diseases / diagnosis
  • Vascular Diseases / physiopathology
  • Vascular Diseases / prevention & control*
  • Vascular Stiffness*
  • Vasodilation*
  • Wisconsin

Associated data

  • ClinicalTrials.gov/NCT01212978