Correlation of Pre-Hypertension with Carotid Artery Damage in Middle-Aged and Older Adults.

The intima-media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and ß-stiffness of the carotid artery (CA) are considered as independent risk factors for cardiovascular diseases (CVDs). Pre-hypertension (PHT) is also an independent CVD risk factor. This study investigated the association between CA damage (CAD) and PHT. A total of 544 adults participated; their blood pressures (BPs) and CA characteristics were measured using a mercury-free sphygmomanometer and ultrasound. Analysis of covariance (ANCOVA) was performed to assess the differences in the CA characteristics according to the BPs, multinomial logistic regression to evaluate the risk of CAD associated with PHT. In ANCOVA, the CA characteristics of PHT were significantly different from normotensive. The odds ratios (ORs) of IMTmax, LDmax, LDmin, peak-systolic FV (PFV), end-diastolic FV (EFV), PFV/LDmin, EFV/LDmax, compliance, and ß-stiffness of PHT were 4.20, 2.70, 3.52, 2.41, 3.06, 3.55, 3.29, 2.02, and 1.84 times higher than those of the normotensive, respectively, in Model 2. In Model 3 adjusted for age, the ORs of LDmax, LDmin, EFV, PFV/LDmin, and EFV/LDmax of PHT were 2.10, 2.55, 1.96, 2.20, and 2.04 times higher than those of the normotensive, respectively. Therefore, the present study revealed that CAD is closely correlated with pre-hypertensive status in adults.

Effect of Schisandra Chinensis Extract Supplementation on Quadriceps Muscle Strength and Fatigue in Adult Women: A Randomized, Double-Blind, Placebo-Controlled Trial.

The fruit of Schisandra chinensis (SC) is a well-known traditional herb used for pharmacological purposes in Asian countries (e.g., Korea, China, and Japan). In animal studies, SC extract supplementation had beneficial effects on muscle strength and lactate level. However, the effect of SC extract supplementation on skeletal muscle strength and lactate at rest in humans remains unclear. The purpose of this study was to evaluate the effect of SC extract supplementation on quadriceps muscle strength (QMS) and lactate at rest in adult women. Forty five healthy post-menopausal middle-aged women (61.9 ± 8.4 years) were randomly divided into the SC (n = 24) or the placebo group (n = 21). The SC group consumed 1000 mg of SC extract per day, whereas the placebo group consumed 1000 mg of starch per day for 12 weeks. The difference in muscle mass, physical function, and biomarkers and the relative changes between baseline and 12 weeks were evaluated. We used two-factor repeated measures analysis of variance (ANOVA) to determine interaction (group × time) effects for variables. Statistical significance was accepted at p < 0.05. In ANOVA results, QMS (p = 0.001) and lactate level (p = 0.038) showed significant interactions. With paired t-tests, QMS was significantly increased (p < 0.001) and lactate level at rest was significantly decreased (p < 0.05) after 12 weeks in the SC group. However, no interactions were found between the other variables. Supplementation of SC extract may help to improve QMS as well as decrease lactate level at rest in adult women. We believe that SC extract is a health supplement that can support healthy life in this population.

Association Between Carotid Artery Intima-Media Thickness and Combinations of Mild Cognitive Impairment and Pre-Frailty in Older Adults.

Carotid intima-media thickness (CIMT) has been proposed as a surrogate marker of cardiovascular disease. Mild cognitive impairment (MCI) and pre-frailty are reportedly associated with increased CIMT. As the evidence on the association of CIMT with combinations of MCI and pre-frailty is limited, this association is examined. A total of 231 older adults participated. MCI was defined according to clinical consensus or psychometric criteria by a dementia specialist, and considering detailed neuropsychological assessments. Also, pre-frailty was defined as subjects with frail component of 1 or 2. Carotid variables were measured using a B-mode ultrasound. The analysis of covariance (ANCOVA) was performed to assess independent differences in CIMT among the four groups, according to the cognitive function and frailty status after a multivariate adjustment. Increased CIMT is associated with combinations of MCI and pre-frailty. ANCOVA showed that CIMTs were significantly different among the four groups according to the cognitive function and frailty status. CIMTmax combined with MCI and pre-frailty was the thickest (1.04 ± 0.3 mm), whereas the CIMT of no MCI and no pre-frailty was the thinnest (0.82 ± 0.2 mm). The results suggest that combinations of MCI and pre-frailty are associated with increased CIMT in older adults.

The effects of the elastin polymorphisms on carotid intima-media thickness in women aged 30 - 70.

PURPOSE: Elastin is one of the major determinants of arterial distensibility of large blood vessels that forms the principal component of elastic fibers from the media of arteries. However, the association between elastin(ELN) genotype and vascular function is still unclear. METHODS: 120women were recruited from the Saha-gu (Busan, Korea) Community Center. Measurements of body composition and vascular function included carotid intima-media thickness (CIMT), carotid artery luminal diameter (CLD), minimum (diastolic) artery luminal diameter (CLDmin) and maximum (systolic) artery luminal diameter (CLDmax). Genotyping for the ELN (rs 2071307) polymorphism was performed using the TaqMan approach. ELN gene distribution of subjects were in the Hardy-Weinberg equilibrium (p=0.402). RESULTS: The relative CIMT differed significantly among the ELN genotypes. And not significant differences in CLD and CIMT/CLD ratio, but AA genotype was tended higher than other genotypes (AG and GG). The relative CIMT and CLD min differed significantly between the ELN alleles. And not significant differences in CLD max and CIMT/CLD ratio, but A allele was tended higher than G allele. CONCLUSION: These results suggest that ELN gene polymorphism might be used a one of the genetic determinants of vascular disease in both pre- and postmenopausal women.

Effects of 24-Week Aerobic and Resistance Training on Carotid Artery Intima-Media Thickness and Flow Velocity in Elderly Women with Sarcopenic Obesity.

AIM: Sarcopenic obesity (SO) is closely associated with cardiovascular disease (CVD) in elderly women. Increases in body fat and decreases in muscle mass are closely associated with increased carotid intima-media thickness (CIMT). The aim of this study was to examine the influence of a 24-week aerobic and resistance training program on carotid parameters in SO. METHODS: Fifty elderly women (74.1±6.1 years) with SO were randomly divided into an exercise group and a control group. The exercise group performed combined exercise over 24 weeks, consisting of resistance and aerobic training for 50-80 min, 5 times a week. Carotid variables were measured using B-mode ultrasound. The differences in the carotid variables and the relative changes between baseline and after 24 weeks were evaluated. RESULTS: In the analysis of variance (ANOVA) results, CIMT (p=0.013), systolic flow velocity (p=0.007), diastolic flow velocity (p=0.006), and wall shear rate (p=0.010) showed significant interactions. In paired t-test results of the exercise group, CIMT significantly decreased (p＜0.01) and systolic flow velocity (p＜0.01), diastolic flow velocity (p＜0.001), and wall shear rate (p＜0.05) significantly increased after 24 weeks. CONCLUSION: The 24-week combined exercise effectively decreased CIMT and increased carotid flow velocity and wall shear ratio. Therefore, combined exercise is thought to contribute to the improvement of the risk of CVD in elderly women with SO.

Muscle strength and carotid artery flow velocity is associated with increased risk of atherosclerosis in adults.

BACKGROUND: Carotid intima-media thickness (CIMT) has been proposed as a surrogate marker of atherosclerotic disease. In addition, carotid flow velocity (FV) and muscle strength (MS) are reported to be associated with increased CIMT. As there remains insufficient evidence for a complex association of CIMT with FV and MS, the aim of this study was to examine this association in adults. METHODS: A total of 426 adults participated in this study. MS in all subjects was measured by hand grip strength. Carotid variables were measured with B-mode ultrasound. Analysis of covariance (ANCOVA) was performed to assess independent differences in the CIMT among four groups, according to the level of peak systolic flow velocity (PSV) and MS after multivariate adjustment. Logistic regression analysis was performed to calculate odds ratios (OR) and 95% confidence intervals (CI) for the independent as-sociations between PSV and MS and the estimated risk of atherosclerosis. RESULTS: Increased CIMT is associated with MS and PSV. ANCOVA showed that the CIMT varied significantly among groups according to the level of PSV and MS after multivariate adjustment. When calculated for the estimated risk of carotid atherosclerosis, the adjusted OR for the low PSV and MS group was 3.87 (95% CI 1.78-8.44). CONCLUSIONS: The results suggest that CIMT and risk of carotid atherosclerosis are significantly cor-related with PSV and upper body MS, more closely for the PSV than for the MS after adjustment for po-tential confounders. PSV by itself, and/or PSV with grip strength may be an indicator of atherosclerotic plaque instability. (Cardiol J 2017; 24, 4: 385-392).

Effects of 6 months of aerobic and resistance exercise training on carotid artery intima media thickness in overweight and obese older women.

AIM: We studied the effects of exercise on carotid intima-media thickness, luminal diameter, and flow velocity in overweight and obese older women, and the associations between carotid parameters changes and other variables. METHODS: A total of 41 overweight and obese older women (aged 65-77 years, fat mass percent ≥ 32%), who were divided into a control group (n = 20) and a supervised combined exercise group (n = 21). The 24-week combined exercise program (aerobic and resistance exercise) consisted of sessions 40-80 min in length 5 days per week under the supervision of an exercise specialist. Body composition, blood pressure, physical function and carotid variables were assessed. The differences in all variables, and the relative changes between baseline and 24 weeks' follow up were evaluated. RESULTS: Carotid intima-media thickness, systolic carotid luminal diameter, peak systolic flow velocity and end diastolic flow velocity showed a significant group × time interaction. No interaction was observed for diastolic luminal diameter. In the exercise group, the change of carotid intima-media thickness was significantly associated with systolic blood pressure, maximal walking speed, 1-mile walking time and maximal oxygen uptake. Also, the change of peak systolic flow velocity was significantly associated with skeletal muscle mass, diastolic blood pressure and maximum walking speed. CONCLUSIONS: Combined exercise can effectively improve carotid intima-media thickness in overweight and obese older women. In addition, exercise training increases the systolic carotid luminal diameter and flow velocity in older women. Therefore, regular combined exercise might help prevent atherosclerotic disease by improving the carotid artery. Geriatr Gerontol Int 2017; 17: 2304-2310.

Effects of 24-week resistance exercise training on carotid peak systolic and end diastolic flow velocity in healthy older adults.

[Purpose] The aim of this study was to examine the effect of resistance exercise on carotid intima-media thickness, luminal diameter, peak systolic flow velocity, end diastolic flow velocity, and wall shear rate in healthy elderly men. [Subjects and Methods] Thirty healthy elderly men (age ≥65 years) were randomly divided into a control (n=15) and resistance exercise (n=15) groups. The 24-week exercise intervention consisted of 3 days of resistance exercise per week using an elastic band per week. Body composition, physical function, blood pressure, and carotid variables were measured at baseline and after 24 weeks. [Results] Body fat percent, skeletal muscle mass, systolic blood pressure, grip strength, arm curl, chair stand up, sit and reach, maximum walking speed, time up and go, and two-minute step test showed significant interaction. Peak systolic flow velocity, end diastolic flow velocity, and wall shear rate also showed significant interaction. [Conclusion] A 24-week resistance exercise program, using elastic bands, effectively improves carotid flow velocity and wall shear rate in healthy elderly men.

The relationship between distribution of body fat mass and carotid artery intima-media thickness in Korean older adults.

[Purpose] The aim of this study was to examine the relationships between the amount and distribution of body fat and the carotid intima-media thickness to explore whether coronary artery disease risk may be mediated through effects on the amount of fat mass in older adults. [Subjects and Methods] A total of 200 elderly females was participated. The percentage of body fat mass was measured by the bioelectrical impedance analysis method, and the carotid intima-media thickness was measured by B-mode ultrasound. Analysis of covariance was performed to assess independent associations between the four categories of percentage of body fat mass and the carotid intima-media thickness after multivariate adjustment. Logistic regression analyses were utilized to calculate odds ratios and 95% confidence intervals for examining independent associations between percentage of body fat mass and the estimated risk of coronary artery disease. [Results] Analysis of covariance showed that the carotid intima-media thickness was significantly thick in both obesity and overweight groups. When multivariate-adjusted OR for the estimated risk of coronary artery disease, the odds ratios for the obesity and overweight groups were 3.0 (95% confidence interval, 1.1 to 8.7) and 2.5 (95% confidence interval, 1.0 to 6.1), respectively. [Conclusion] This study demonstrates that elderly females with a high body fat mass are more likely to have the estimated risk of CAD than who fit body fat mass in elderly female.

Effects of a 12-week healthy-life exercise program on oxidized low-density lipoprotein cholesterol and carotid intima-media thickness in obese elderly women.

[Purpose] This study examined the effects of a 12-week exercise program on plasma level of oxidized low-density lipoprotein cholesterol in obese elderly women, who are at increased risk of heart disease morbidity. [Subjects and Methods] Twenty participants were assigned into either a control (n = 10) or a supervised exercise program (n = 10) group. The 12-week exercise intervention was performed 3 days per week and involved combined aerobic exercise, resistance exercise, and traditional Korean dance. [Results] Two-factor analysis of variance revealed significant group × time interactions for body mass, diastolic blood pressure, appendicular muscle mass. For high-density lipoprotein cholesterol, oxidized low-density lipoprotein cholesterol, and the ratio of oxidized low-/high-density lipoprotein cholesterol, two-factor analysis of variance revealed significant interactions (group × time), indicating responses differed significantly between the control and exercise groups after 12 weeks. [Conclusion] A 12-week low- to moderate-intensity exercise program appears to be beneficial for obese elderly women by improving risk factors for cardiovascular disease.

Effects of a healthy life exercise program on arteriosclerosis adhesion molecules in elderly obese women.

[Purpose] The aim of this study was to investigate the change in the arteriosclerosis adhesion molecules after a healthy life exercise program that included aerobic training, anaerobic training, and traditional Korean dance. [Subjects] The subjects were 20 elderly women who were over 65 years of age and had 30% body fat. [Methods] The experimental group underwent a 12-week healthy life exercise program. To evaluate the effects of the healthy life exercise program, measurements were performed before and after the healthy life exercise program in all the subjects. [Results] After the healthy life exercise program, MCP-1 and the arteriosclerosis adhesion molecules sE-selectin and sVCAM-1 were statistically significantly decreased. [Conclusion] The 12-week healthy life exercise program reduced the levels of arteriosclerosis adhesion molecules. Therefore, the results of our study suggest that a healthy life exercise program may be useful in preventing arteriosclerosis and improving quality of life in elderly obese women.

A 12-week after-school physical activity programme improves endothelial cell function in overweight and obese children: a randomised controlled study.

BACKGROUND: Endothelial dysfunction is associated with childhood obesity and is closely linked to the amount and function of endothelial progenitor cells. However, it remains unclear whether endothelial progenitor cells increase with after-school exercise in overweight and obese children. The purpose of this study was to investigate the effects of an after-school exercise programme on endothelial cell function in overweight and obese children. METHODS: A total of 29 overweight/obese children (12.2 ± 0.1 years) were randomly divided into control (i.e. no after-school exercise, n = 14) and after-school exercise (n = 15) groups. The 12-week after-school exercise intervention consisted of 3 days of combined aerobic and resistance exercise per week. Each 80-minute exercise programme included 10 minutes of warm-up and 10 minutes of cool-down after school. CD34(+) (a cell surface marker on hematopoietic stem cells), CD133(+) (a cell surface marker on hematopoietic progenitor cells) and CD34(+)/CD133(+) (considered as endothelial progenitor cells) were measured at baseline and after 12 weeks using flow cytometry. RESULTS: Increased percentages of CD34(+), CD133(+) and CD34(+)/CD133(+) cells were observed in the after-school exercise group (p = 0.018; p = 0.001; p = 0.002, respectively) compared with the control group. Carotid intima-media thickness decreased after 12 weeks in the after-school exercise group (p = 0.020) compared with the control group. CONCLUSIONS: This study provides preliminary evidence that a combined after-school exercise programme may represent an effective intervention strategy for improving vascular repair and endothelial cell function, leading to improved cardiovascular health in overweight and obese children. TRIAL REGISTRATION: Current Controlled Trials ISRCTN19037201.