Associations between physical activity and cardiorespiratory fitness with vascular health phenotypes in older adults: a cross-sectional study.

Objective: We investigated the associations between physical activity (PA) and cardiorespiratory fitness (CRF) with vascular health phenotypes in community-dwelling older adults. Methods: This cross-sectional study included 82 participants (66.8 ± 5.2 years; 81% females). Moderate-to-vigorous physical activity (MVPA) was assessed using accelerometers, and CRF was measured using the distance covered in the 6-min walk test (6MWT). The vascular health markers were as follows: i) arterial function measured as aortic pulse wave velocity (aPWV) estimated using an automatic blood pressure device; and ii) arterial structure measured as the common carotid intima-media thickness (cIMT). Using a combination of normal cIMT and aPWV values, four groups of vascular health phenotypes were created: normal aPWV and cIMT, abnormal aPWV only, abnormal cIMT only, and abnormal aPWV and cIMT. Multiple linear regression was used to estimate the beta coefficients (ß) and their respective 95% confidence intervals (95% CI) adjusting for BMI, and medication for diabetes, lipid, and hypertension, sex, age, and blood pressure. Results: Participants with abnormal aPWV and normal cIMT (ß = -53.76; 95% CI = -97.73--9.78 m; p = 0.017), and participants with both abnormal aPWV and cIMT (ß = -71.89; 95% CI = -125.46--18.31 m; p = 0.009) covered less distance in the 6MWT, although adjusting for age, sex and blood pressure decreased the strength of the association with only groups of abnormal aPWV and cIMT covering a lower 6MWT distance compared to participants with both normal aPWV and cIMT (ß = -55.68 95% CI = -111.95-0.59; p = 0.052). No associations were observed between MVPA and the vascular health phenotypes. Conslusion: In summary, poor CRF, but not MVPA, is associated with the unhealthiest vascular health phenotype (abnormal aPWV/cIMT) in older adults.

Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases.

PURPOSE: Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. METHODS: In total, 249 community-dwelling older adults aged 60-80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. RESULTS: From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (ß = 0.19 m/s; p = 0.007) compared to their robust peers. CONCLUSIONS: The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60-80 years. Pre-frail older adults may have a higher risk for CVD.

Housing type is associated with objectively measured changes in movement behavior during the COVID-19 pandemic in older adults with hypertension: An exploratory study.

PURPOSE: To investigate the association between housing characteristics with objectively measured changes in physical activity (PA) and sedentary behavior (SB) during the COVID-19 pandemic in older adults with hypertension. METHODS: Thirty-five older adults with hypertension were included in this exploratory study. Accelerometer-based PA and SB measures were assessed before and during a period of social distancing policy imposed due to the COVID-19 pandemic. Housing type, housing surface area and household size were tested as predictors of changes in PA and SB. A generalized linear mixed model was used for the analysis. RESULTS: Housing type was associated with changes in PA and SB. Individuals residing in an apartment showed a greater decrease in light PA on weekdays (ß= -65 min/day, p=0.035) and a trend for an increase in SB (ß= 55 min/day, p=0.056) compared to those residing in a detached house. Individuals residing in a row house showed a greater decrease in moderate-vigorous PA (ß= -10 min/day, p=0.037) and steps/day (ß= -2064, p=0.010) compared to those residing in a detached house. Individuals residing in an apartment showed a greater decrease in light PA on the weekends (ß= -83 min/day, p=0.015) and an increase in SB (ß= 72 min/day, p=0.036) compared to those residing in a detached house. No association was found for housing surface area and household size. CONCLUSIONS: Older adults with hypertension residing in an apartment or row house have greater unhealthy changes in movement behavior during the COVID-19 pandemic. Further studies are needed to confirm our preliminary findings.

Short-Term Effect of Self-Selected Training Intensity on Ambulatory Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial.

PURPOSE: To investigate the short-term effect of self-selected training intensity (SSTI) on ambulatory blood pressure (BP) in hypertensive older women. PARTICIPANTS AND METHODS: This is a randomized, single-blind, two-arm, parallel-group controlled trial that included 40 medicated hypertensive older women (64.4±3.6 years; resting systolic 118±19 and diastolic BP 68±9 mmHg). SSTI intervention was performed three times per week, 30-50 minutes per session (n=20). The control group participated in health education meetings once per week (n=20). Ambulatory BP (primary outcome) and six-minute walking test performance (secondary outcome) were assessed at baseline and following 8 weeks of intervention. Heart rate (HR), rating of perceived exertion (RPE, 6-20), and affective valence (ie, feeling scale, -5/+5) were recorded during all SSTI sessions. Intention-to-treat and per-protocol analyses were used for data analyses. RESULTS: Fifteen participants from the SSTI group and 17 from the control group completed the study. No differences in ambulatory BP (24-h, awake, and asleep) were observed between SSTI and control groups (intention-to-treat and per-protocol analyses; p>0.05). The SSTI group showed a greater six-minute walking test performance than the control group in the intention-to-treat and per-protocol analyses (p<0.05). The participants exercised at 52±10% of HR reserve reported an RPE of 11±1 and an affective valence of 3.4±1.1 over the 8-week period. CONCLUSION: SSTI is a feasible approach to induce a more active lifestyle and increase health-related fitness in hypertensive older women, although it does not improve BP control over a short-term period.

Independent and combined associations of cardiorespiratory fitness and muscle strength with metabolic syndrome in older adults: A cross-sectional study.

BACKGROUND: Studies have shown that low cardiorespiratory fitness (CRF) and low muscle strength are independently associated with metabolic syndrome (MetS) in older adults. This study investigated the isolated and combined associations of low CRF and muscle strength with MetS in older adults. METHODS: This cross-sectional study included 184 older adults (71% women; aged 65.6 ±â€¯4.3 years) without a prior history of cardiovascular disease. CRF and muscle strength were assessed by the six-minute walking test and 30-s chair stand test, respectively. Results below the 25th percentile of the cohort were used to define low CRF and low muscle strength. MetS was defined according to NCEP-ATP III criteria. Poisson's regression with robust variance was used to determine the prevalence ratio (PR) for MetS. Reference group was composed by older adults with both CRF and muscle strength above 25th percentile. RESULTS: Prevalence of low CRF, low muscle strength, and combined low CRF and muscle strength was 22.8%, 17.9%, and 10.9%, respectively. The prevalence of MetS was 56.5% in the full cohort. Isolated low CRF (PR 1.05, 95% CI 0.73 to 1.52; p = 0.793) and muscle strength (PR 1.09, 95% CI 0.74 to 1.61; p = 0.651) were not associated with MetS in the adjusted analysis. Combined low CRF and muscle strength was associated with MetS (PR 1.45, 95% CI 1.09 to 1.93; p = 0.011). CONCLUSIONS: Older adults with combined, but not isolated, low CRF and muscle strength showed an increased risk for MetS.

Self-selected exercise intensity for inactive hypertensive older women: a pilot study / Exercício em intensidade autosselecionada para mulheres idosas hipertensas inativas: um estudo piloto

Self-selected exercise intensity (SSE) is a simple approach to encourage an active lifestyle. This study aimed to investigate whether a SSE session meet the recommended intensity for hypertension management (i.e. moderate-vigorous), and whether heart rate (HR), rating of perceived exertion (RPE) and affective responses are reproducible. Thirteen inactive hypertensive older women (age: 64.54 ± 4.16 years; blood pressure: 122.51/62.15 mmHg) performed two 30-minute SSE sessions outdoors. HR reserve (HRR), RPE and affective responses were assessed. Paired t-test, intraclass correlation coefficient (ICC) and typical error (TE) were used for the analyzes. Participants exercised at moderate-vigorous intensity (≥ 40% of HRR). No differences were found for HRR (56.46 ± 8.01% vs. 59.08 ± 10.57%), RPE (11.26 ± 1.14 vs. 10.98 ± 1.52) and affective response (3.47 ± 1.13 vs. 3.38 ± 1.23) (p > 0.05). RPE showed excellent reliability (ICC = 0.82; 95%CI: 0.42; 0.94; p = 0.003). There was a poor reliability for HRR (ICC = 0.40; 95%CI: -0.97; 0.82; p = 0.193) and affective responses (ICC = 0.19; 95%CI: -2.10; 0.76; p = 0.369). TE between sessions for HRR, RPE, and affective response were 8.11 bpm, 0.75 and 1.11, respectively. In conclusion, inactive hypertensive older women seem to meet the recommended intensity for hypertension management when they exercise at a self-selected pace and report it as light-moderate and pleasant. Despite only RPE, but not HR and affective response, has shown good reproducibility, the results seem to support the use of SSE as a simple approach to encourage an active lifestyle in this population

O exercício em intensidade autosselecionada (EIA) é uma abordagem simples para encorajar um estilo de vida ativo. Este estudo investigou se o EIA atende a intensidade recomendada para tratamento de hiperten-são (i.e. moderada-vigorosa), e se a frequência cardíaca (FC), percepção de esforço (PSE) e resposta afetiva são reprodutíveis. Treze mulheres idosas hipertensas inativas (idade: 64,54 ± 4,16 anos; pressão arterial: 122,51/62,15 mmHg) realizaram duas sessões de EIA de 30 minutos ao ar livre. FC de reserva (FCR), PSE e resposta afetiva foram avaliadas. Teste t pareado, coeficiente de correção intraclasse (CCI) e erro tí-pico (ET) foram analisados. As participantes se exercitaram em intensidade moderada-vigorosa (≥ 40% da FCR). Não houve diferença na FCR (56,46 ± 8,01% vs. 59,08 ± 10,57%), PSE (11,26 ± 1,14 vs. 10,98 ± 1,52) e resposta afetiva (3,47 ± 1,13 vs. 3,38 ± 1,23; p > 0,05). A PSE apresentou excelente confiabilidade (CCI = 0,82; IC95%: 0,42; 0,94; p = 0,003). Houve baixa confiabilidade da FCR (CCI = 0,40; IC95%: -0,97; 0,82; p = 0,193) e resposta afetiva (CCI = 0,19; IC95%: -2,10; 0,76; p = 0,369). O ET foi de 8,11 bpm, 0,75 e 1,11 para FCR, PSE e resposta afetiva, respectivamente. Em conclusão, mulheres idosas hipertensas inativas parecem atender a intensidade recomendada para tratamento da hipertensão quando realizam EIA e relatam a atividade como leve-moderada e prazerosa. Embora apenas a PSE, e não a FCR e resposta afetiva, tenha mostrado boa reprodutibilidade, os resultados parecem suportar o EIA como uma abordagem simples para encorajar um estilo de vida ativo nessa população

Acute antihypertensive effect of self-selected exercise intensity in older women with hypertension: a crossover trial.

PURPOSE: Acute reduction in blood pressure (BP) following an exercise session is evidenced in controlled settings with formal supervision in hypertensive older populations. This study investigated the effect of a self-selected exercise (SSE)-intensity session on ambulatory BP in hypertensive older women in a "real-world" setting. METHODS: Twenty inactive older women with hypertension (64.9±4.5 years) were included in this randomized, controlled, crossover trial. After baseline assessments, participants performed 30 minutes of an SSE-intensity session on an outdoor track and a control session, separated by 7-10 days. Heart rate (HR), rating of perceived exertion (RPE), and affective response were assessed. Ambulatory BP was monitored for 20 hours following both sessions. Paired t-tests and generalized estimation were used for data analysis. RESULTS: Participants exercised at 5.1±1.1 km/h, spent ~90% of the exercise time at moderate-vigorous intensity (≥40% of heart rate reserve). SSE-intensity session was reported as light (RPE 11.0±1.5) and pleasant (affect 3.4±1.2). SSE-intensity session elicited reductions in systolic BP in the first 6 hours postexercise (6.0 mmHg, CI 2.7-9.3 mmHg; P<0.001). Average systolic BP in the 20-hour (-3.4 mmHg, CI -5.9 to -0.9 mmHg; P=0.010) and awake (-4.0 mmHg, CI -6.4 to -1.6 mmHg; P=0.003) periods were lower following SSE-intensity session compared to control session. No differences were observed in average systolic BP during asleep period and diastolic BP during the 20-hour awake and asleep periods between the SSE-intensity session and control session (P>0.05). CONCLUSION: An SSE-intensity session elicited a reduction in ambulatory systolic BP in inactive older women with hypertension during awake and 20-hour periods. Also, the SSE-intensity session was reported as light and pleasant.

Physiological and Psychological Responses during Low-Volume High-Intensity Interval Training Sessions with Different Work-Recovery Durations.

We compared physiological and psychological responses between low-volume high-intensity interval training (LV-HIIT) sessions with different work-recovery durations. Ten adult males performed two LV-HIIT sessions in a randomized, counter-balanced order. Specifically, 60/60 s LV-HIIT and 30/30 s LV-HIIT. Oxygen uptake (VO2), carbon dioxide output (VCO2), ventilation (VE), respiratory exchange ratio (RER), perceived exertion (RPE), and affect were assessed. During intervals, the VO2 (3.25 ± 0.57 vs. 2.83 ± 0.50 L/min), VCO2 (3.15 ± 0.61 vs. 2.93 ± 0.58 L/min), VE (108.59 ± 27.39 vs. 94.28 ± 24.98 L/min), and RPE (15.9 ± 1.5 vs. 13.9 ± 1.5) were higher (ps ≤ 0.01), while RER (0.98 ± 0.05 vs. 1.03 ± 0.03) and affect (-0.8 ± 1.4 vs. 1.1 ± 2.0) were lower (ps ≤ 0.007) in the 60/60 s LV-HIIT. During recovery periods, VO2 (1.85 ± 0.27 vs. 2.38 ± 0.46 L/min), VCO2 (2.15 ± 0.35 vs. 2.44 ± 0.45 L/min), and affect (0.6 ± 1.7 vs. 1.7 ± 1.8) were lower (ps ≤ 0.02), while RER (1.20 ± 0.05 vs. 1.03 ± 0.05; p < 0.001) was higher in the 60/60 s LV-HIIT. Shorter LV-HIIT (30 s) elicits lower physiological response and attenuated negative affect than longer LV-HIIT (60 s).

Efeito do tempo sentado prolongado sobre marcadores cardiometabólicos em adultos fisicamente ativos e inativos: um estudo piloto / Effect of prolonged sitting time on cardiometabolic markers in physically active and inactive adults: a pilot study

O objetivo deste estudo foi analisar o efeito do tempo sentado prolongado sobre marcadores cardio-metabólicos em adultos fisicamente ativos e inativos. Participaram do estudo 10 adultos fisicamente ativos (27,30 ± 4,90 anos de idade) e 11 fisicamente inativos (26,27 ± 3,17 anos de idade). Todos realizaram uma sessão de tempo sentado prolongado de 10 horas, com quatro refeições padroniza-das. Os níveis de glicose e pressão arterial foram mensurados no jejum, antes e 1 hora após cada refeição e também 2 horas após o almoço. Os níveis de triglicerídeos foram medidos no jejum, 2 e 3,5 horas após o almoço. O modelo linear generalizado foi utilizado para comparar a área sob a curva incremental (ASCi) dos níveis de glicose e triglicerídeos e a área sob a curva (ASC) dos níveis de pressão arterial entre os grupos, com ajuste pelos valores de linha de base. O grupo fisicamente ativo apresentou menor ASCi para os níveis de glicose no período de 10 horas (ß = -5,55 mg/dL/10h; IC95%: -9,75; -1,33; p = 0,010) e no período da manhã (ß = -7,05 mg/dL/5h; IC95%: -12,11; -1,99; p = 0,006) comparado ao grupo fisicamente inativo. Não houve diferença da ASCi dos triglicerídeos (p = 0,517) e na ASC da pressão arterial (p = 0,145) entre os grupos. Em conclusão, adultos fisicamente ativos apresentaram melhor controle glicêmico comparados àqueles fisicamente inativos durante a exposição a tempo sentado prolongado

The purpose of this study was to analyze the effect of prolonged sitting time on cardiometabolic markers in physically active and inactive adults.Ten physically active adults (27.30 ± 4.90 years old) and 11 physically inactive (26.27 ± 3.17 years old) participated in the study. All performed a 10-hour long sitting session, with a total of four standardized meals. Glucose and blood pressure levels were measured at fasting, before and 1 hour after each meal, and 2 hours after lunch. Triglycerides levels were measured on fasting at 2 and 3.5 hours after lunch. The generalized linear model was used to compare the area under the incremental curve (AUCi) of the glucose and triglycerides lev-els, and the area under the curve (AUC) of the blood pressure levels between the groups, adjusted for baseline values. The physically active group showed lower blood glucose AUCi of 10 hours (ß = -5.55 mg/dL/10h; 95%CI: -9.75; -1.33, p = 0.010), and morning (ß = -7.05 mg/dL/5h; 95%CI: -12.11; -1.99, p = 0.006) compared to the physically inactive group. There was no difference in triglycerides AUCi (p = 0.517) and blood pressure AUC (p = 0.145) between groups. In conclusion, physically active adults have better glycemic control than physically inactive adults during exposure to prolonged sitting time