Aerobic training in older adults with type 2 diabetes and vasodepressive carotid sinus hypersensitivity

Madden, Kenneth M.; Lockhart, Christopher; Cuff, D.; Potter, Tiffany; Meneilly, Graydon S.

doi:10.1007/s40520-013-0160-4

Cited by 7 publications

(9 citation statements)

References 26 publications

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“…There are other alternative physical activity programs that can be undertaken within the safe confines of home. Regular exercise training has been advocated as part of numerous practice guidelines, including the ADA, the American College of Sports Medicine, the American Heart Association (AHA), and the Canadian Diabetes Association [ 23 ]. Exercise has been shown to improve immunity, though it might be prudent to be careful and avoid crowded places like gymnasia or swimming pools [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

Self- management of diabetes mellitus during the Covid-19 pandemic: Recommendations for a resource limited setting

Mukona

Zvinavashe

2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background and aims The COVID-19 pandemic has challenged both institutional and self-management of diabetes. The ongoing social distancing and lock downs have negatively impacted to access to care and self-management. Methods This is a narrative review of diabetes management in a resource limited setting during the ongoing COVID-19 pandemic. Electronic databases, namely; Pubmed, CINAHL, EMBASE and Google Scholar were searched for literature. Search terms were “corona virus”, “COVID-19”, “diabetes self-care”, “diabetes self-management education”, “DSME”, “diabetes self-management”, “diabetes self-care in low income countries” and “diabetes management in Zimbabwe”. Results This paper suggests a culturally tailored educational plan on diabetes self-management of diabetes in a limited resource country, Zimbabwe, amid the ongoing COVID-19 pandemic. Components of health education comprised general preventive measures, medications, diet, physical activity, self-monitoring of blood glucose, stress management, foot care, smoking and drinking and preventing complications of diabetes mellitus. Conclusions We have reemphasized the need for self-care, social support and a collaborative, patient-centered approach to care amid the ongoing COVID-19 pandemic.

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Section: Resultsmentioning

confidence: 99%

Self- management of diabetes mellitus during the Covid-19 pandemic: Recommendations for a resource limited setting

Mukona

Zvinavashe

2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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“…Hence, interventions in individuals with type 2 diabetes that can improve these markers of arterial health are critically important for preventing and/or delaying adverse cardiovascular events and mortality. Exercise training of different types and intensities has been shown to be an effective strategy for improving PWV and IMT in individuals with type 2 diabetes [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Vascular improvements in individuals with type 2 diabetes following a 1 year randomised controlled exercise intervention, irrespective of changes in cardiorespiratory fitness

et al. 2020

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Aims/hypothesis Vascular changes in individuals with type 2 diabetes mellitus majorly contribute to the development of cardiovascular disease. Increased cardiorespiratory fitness (CRF) has been associated with improvements in vascular health. Although CRF tends to improve with exercise training, there remains a portion of participants with little or no improvement. Given the importance of vascular function in individuals with type 2 diabetes, we assessed whether individuals who failed to improve CRF following a 1 year exercise intervention also failed to improve arterial stiffness and structural indices. Methods Individuals with type 2 diabetes with no major micro-and macrovascular complications and aged between 30 and 75 years old (n = 63) participated in a three-arm, 1 year, randomised controlled exercise intervention in Lisbon, Portugal. The study involved a non-exercise control group, a moderate continuous training combined with resistance training (RT) group and a high-intensity interval training with RT group. Allocation of participants into the intervention and control groups was done using a computer-generated list of random numbers. An improvement in CRF was defined as a change in V O 2peak ≥5%. Vascular stiffness and structural indices were measured using ultrasound imaging and applanation tonometry. Generalised estimating equations were used to compare changes in vascular measures across individuals in the control group (n = 22) and those in the exercise groups who either had improved CRF (CRF responders; n = 14) or whose CRF did not improve (CRF non-responders; n = 27) following 1 year of exercise training. Results Compared with the control group, exercisers, with and without improvements in CRF, had decreased carotid intimamedia thickness (IMT) (CRF responders: β = −2.84 [95% CI −5.63, −0.04]; CRF non-responders: β = −5.89 [95% CI −9.38, −2.40]) and lower-limb pulse wave velocity (PWV) (CRF responders: β = −0.14 [95% CI −0.25, −0.03]; CRF non-responders: β = −0.14 [95% CI −0.25, −0.03]), the latter being an indicator of peripheral arterial stiffness. Only CRF responders had decreased PWVof the upper limb compared with control participants (β = −0.12 [95% CI −0.23, −0.01]). As for central stiffness, CRF non-responders had increased aortic PWV compared with CRF responders (β = 0.19 [95% CI 0.07, 0.31]), whereas only the CRF non-responders had altered carotid distensibility coefficient compared with the control group (β = 0.00 [95% CI 3.01 × 10 −5 , 0.00]). No interaction effects between the CRF responders and non-responders vs control group were found for the remaining stiffness or haemodynamic indices (p>0.05).

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“…Conversely, long-term regular physical activity appears to prevent structural changes in the arterial walls that relate to the covalent crosslinking between long-lived proteins (such as collagen) and advanced glycation end-products (Takeuchi, 2020). While aerobic training introduced following the onset of cardiovascular disease can work to reduce arterial stiffness in older adults, the longevity of the improvements is unclear (Madden et al, 2013), which may explain the beneficial, but weak to moderate relationship between physical activity and PWV in our study. Moreover, our results indicated a weak correlation between PWV and the anaerobically-powered sit-to-stand test, whereas there was a moderate correlation between PWV and the aerobically-powered 6-MWT (See Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…The strength of the relationship between a higher number of risk factors and increased PWV may help to explain the moderate relationship between overall physical activity and PWV (see Table 3). In this regard, findings by Madden et al (2013) suggest that there is at least some irreversible arterial damage that occurs in individuals with multiple risk factors for arterial stiffness, such as advanced age, diabetes, hypertension or hypercholesterolemia. Therefore, in those participants with one or more risk factors for cardiovascular disease, the beneficial effect of physical activity on PWV is not strong enough to overcome the damaging effect of the risk factors on the arterial walls (and therefore off-set the beneficial relationship between physical activity and PWV).…”

Section: Discussionmentioning

confidence: 99%

Physical activity has a stronger correlation with arterial stiffness than strength, balance, or BMI in an older population

Hill,

Elliot,

Lizamore

et al. 2023

Front. Aging

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Background: Arterial stiffness is associated with an array of debilitating health conditions. While exercise typically has beneficial effects on both arterial stiffness and overall health, more research is needed to understand the associations of different types of fitness indices with arterial stiffness.Aim: To investigate the relationship between balance, strength, cardiovascular fitness and physical activity with arterial stiffness (as measured by pulse wave velocity (PWV)) in older adults.Method: Eighty retirement-village residents (24 males, 56 females, age: 78.2 ± 6.4 years, weight: 69.4 ± 12.5 kg, height: 162.9 ± 8.5 cm) completed the Yale Physical Activity Survey, PWV measurement, 30-s sit-to-stand leg strength test, hand grip strength assessment, 4-stage balance test, and a 6-min walk fitness test. The number of exiting risk factors (smoking, previous heart incidents, previous stroke(s), having hypertension, or taking anti-hypertension medication) were tallied. Pearson’s correlations were used to assess the relationship between PWV and health and fitness parameters. Results were interpreted using qualitative inference.Results: The number of risk factors (r = 0.57, p < 0.001), age (r = 0.51, p < 0.001) and systolic blood pressure (r = 0.50, p = 0.001) had strong, harmful associations with PWV. Total physical activity minutes/week (r = −0.31 p = 0.01), total energy expenditure Kcal/week (r = −0.30, p = 0.01), and the 6-min walk test (r = −0.29, p = 0.01) had a moderate, beneficial association with PWV, while sit-to-stand (r = −0.27, p = 0.02) and balance (r = −0.27, p = 0.01) had a weak, beneficial association with PWV. Hand grip strength (r = 0.02, p = 0.94) and body mass index (r = −0.04, p = 0.75) had no significant associations with PWV.Discussion: All measured fitness indices had beneficial associations with PWV. However, having more risk factors, increased age, and higher systolic blood pressure had significant (harmful) associations with PWV in our older population.Conclusion: Controlling cardiovascular risk factors, especially high systolic blood pressure, is likely to have the largest beneficial effect on PWV. Improving general physical activity, including walking capacity, may prove beneficial in improving PWV in an older population.

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Aerobic training in older adults with type 2 diabetes and vasodepressive carotid sinus hypersensitivity

Abstract: Aerobic training has no effect on the SBP response to CSM in OADM subjects with V-CSH. Unlike in other neuroautonomic etiologies for fainting, aerobic exercise is not effective as a treatment for V-CSH, at least in the OADM population.

Cited by 7 publications

References 26 publications

Self- management of diabetes mellitus during the Covid-19 pandemic: Recommendations for a resource limited setting

Self- management of diabetes mellitus during the Covid-19 pandemic: Recommendations for a resource limited setting

Vascular improvements in individuals with type 2 diabetes following a 1 year randomised controlled exercise intervention, irrespective of changes in cardiorespiratory fitness

Physical activity has a stronger correlation with arterial stiffness than strength, balance, or BMI in an older population

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