Association of cardiorespiratory fitness level with vascular function and subclinical atherosclerosis in the elderly

Eur J Appl Physiol. 2024 May;124(5):1487-1497. doi: 10.1007/s00421-023-05375-1. Epub 2023 Dec 22.

Abstract

Purpose: Physical exercise is crucial for healthy aging and plays a decisive role in the prevention of atherosclerotic cardiovascular disease (ASCVD). A higher level of cardiorespiratory fitness (CRF) in the elderly is associated with lower cardiovascular and all-cause mortality. This study investigated the association of CRF level with vascular function and cardiovascular risk factors in the elderly.

Methods: We examined 79 apparently healthy and physically active subjects aged > 55 years (64 ± 4 years). Cardiovascular functional parameters assessed included brachial and central blood pressure (BP), pulse wave velocity (PWV), augmentation index (Aix), and ankle-brachial index. Sonography of the common carotid artery was performed. CRF level was determined by a cardiopulmonary exercise test, and everyday activity was quantified with an accelerometer.

Results: All participants had a higher CRF level than the reported age-specific normative values. Twenty-nine subjects had subclinical atherosclerosis of the common carotid artery. Compared with participants without atherosclerosis, they were older (p = 0.007), displayed higher brachial systolic BP (p = 0.006), and higher central systolic BP (p = 0.014). Lower brachial (p = 0.036) and central (p = 0.003) systolic BP, lower PWV (p = 0.004), lower Aix (p < 0.001), lower body fat percentage (< 0.001), and lower LDL cholesterol (p = 0.005) were associated with a higher CRF level.

Conclusions: In this cohort of healthy and physically active individuals, subjects with subclinical atherosclerosis displayed higher systolic brachial and central BP. A higher CRF level was associated with enhanced vascular function, consistent with an influence of CRF on both BP and vascular function in the elderly.

Keywords: Cardiorespiratory fitness; Cardiovascular risk factors; Elderly athletes; Pulse wave analysis; Subclinical atherosclerosis; Vascular function.

MeSH terms

  • Aged
  • Ankle Brachial Index
  • Atherosclerosis* / physiopathology
  • Blood Pressure / physiology
  • Cardiorespiratory Fitness* / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulse Wave Analysis
  • Vascular Stiffness / physiology