Exercise and the Cardiovascular System

Lavie, Carl J.; Arena, Ross; Swift, Damon L.; Johannsen, Neil M.; Sui, Xuemei; Lee, Duck Chul; Earnest, Conrad P.; Church, Timothy S.; O’Keefe, James H.; Milani, Richard V.; Blair, Steven N.

doi:10.1161/circresaha.117.305205

Cited by 611 publications

(259 citation statements)

References 132 publications

(200 reference statements)

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“…Second, baPWV actually reflects the stiffness of the large‐ to medium‐sized arteries11, 12, 14; therefore, the importance of aortic stiffness in blood pressure elevation could not be examined precisely in this study. Third, the effect of habitual exercise, which is well known to affect the blood pressure and arterial stiffness,19 was not examined in the present study. Fourth, we could not examine the mechanism underlying the etiological basis of development of hypertension (ie, primary or secondary).…”

Section: Discussionmentioning

confidence: 95%

Effect of Wave Reflection and Arterial Stiffness on the Risk of Development of Hypertension in Japanese Men

Tomiyama

Komatsu

Shiina

et al. 2018

JAHA

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BackgroundWe conducted analyses of repeated‐measures data to examine whether pressure wave reflection acts additively or synergistically with arterial stiffness in the pathogenesis of hypertension.Methods and ResultsIn 3172 middle‐aged (42±9 years) healthy Japanese men without hypertension at the study baseline, systolic and diastolic blood pressures, brachial–ankle pulse wave velocity, and radial augmentation index were measured annually during a 9‐year study period. Of these, 474 participants (15%) developed hypertension by the end of the study period. Binary logistic regression analysis demonstrated significant individual odds ratios for both baseline brachial–ankle pulse wave velocity and radial augmentation index for the development of hypertension. The rate of onset of hypertension during the study period was highest in the participant group with high values for both brachial–ankle pulse wave velocity and radial augmentation index at study baseline (262 of 965 participants: 27%). The generalized estimating equation analysis revealed that both radial augmentation index (estimate=0.06, SE=0.03, P=0.05) and brachial–ankle pulse wave velocity (estimate=0.07×10−1, SE=0.02×10−1, P<0.01) showed significant longitudinal association with new onset of hypertension, with no significant interaction.ConclusionsIn Japanese men, abnormal wave reflection and increased arterial stiffness may be additively associated with the risk of new onset of hypertension. Abnormal wave reflection and elevated central blood pressure may be longitudinally associated with increase in arterial stiffness, and this longitudinal association may be a mechanism underlying the additive effect of these 2 variables on the risk of new onset of hypertension.

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Section: Discussionmentioning

confidence: 95%

Effect of Wave Reflection and Arterial Stiffness on the Risk of Development of Hypertension in Japanese Men

Tomiyama

Komatsu

Shiina

et al. 2018

JAHA

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“…[34][35][36] This evidence applies not only to healthy individuals but also to patients with CVD, in whom exercise, particularly aerobic exercise, has shown to have multiple health benefits. 37 Closely related with PA, obesity and health is cardiorespiratory fitness as assessed by maximal (or submaximal) exercise tests (typically on a treadmill or cycle-ergometer) and usually expressed in terms of maximal oxygen consumption (mL/kg per minute). In this context, the Aerobics Center Longitudinal Study (ACLS) has been one of the major contributors to consistently demonstrate the power of cardiorespiratory fitness as a predictor of CVD morbidity and mortality.…”

Section: Fat-but-fit Paradigm and Cvdmentioning

confidence: 99%

Obesity and Cardiovascular Disease

Ortega

Lavie

Blair

2016

Circulation Research

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927

603

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T here is overall agreement in the scientific and clinical community that obesity is one of the major public health problems of this century. The first documented reports on obesity date from the end of the 19th century and the beginning of the 20th century.1-3 From these days to date, >57 000 articles have been published in PubMed including the term obesity in the title, with these figures being 3× larger when searching by obesity also in the abstract. Figure 1 graphically Abstract: The prevalence of obesity has increased worldwide over the past few decades. In 2013, the prevalence of obesity exceeded the 50% of the adult population in some countries from Oceania, North Africa, and Middle East. Lower but still alarmingly high prevalence was observed in North America (≈30%) and in Western Europe (≈20%). These figures are of serious concern because of the strong link between obesity and disease. In the present review, we summarize the current evidence on the relationship of obesity with cardiovascular disease (CVD), discussing how both the degree and the duration of obesity affect CVD. Although in the general population, obesity and, especially, severe obesity are consistently and strongly related with higher risk of CVD incidence and mortality, the one-sizefits-all approach should not be used with obesity. There are relevant factors largely affecting the CVD prognosis of obese individuals. In this context, we thoroughly discuss important concepts such as the fat-but-fit paradigm, the metabolically healthy but obese (MHO) phenotype and the obesity paradox in patients with CVD. About the MHO phenotype and its CVD prognosis, available data have provided mixed findings, what could be partially because of the adjustment or not for key confounders such as cardiorespiratory fitness, and to the lack of consensus on the MHO definition. In the present review, we propose a scientifically based harmonized definition of MHO, which will hopefully contribute to more comparable data in the future and a better understanding on the MHO subgroup and its CVD prognosis. (Circ Res.

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“…(Myers, 2014). As stated above, improvements in CRF as calculated by e-CRF may lead to additional improvements in other CHD risk factors, such as hypertension and glycemic control and could potentially be considered as part of primary and secondary prevention (Ross et al, 2016;Vuori et al, 2013;Swift et al, 2013;Lavie et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Addition of Estimated Cardiorespiratory Fitness to the Clinical Assessment of 10-Year Coronary Heart Disease Risk in Asymptomatic Men

Gander¹

2015

Medicine &Amp; Science in Sports &Amp; Exercise

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The Framingham Risk Score (FRS) was developed to quantify a patient's coronary heart disease (CHD) risk. Nonexercise estimated CRF (e-CRF) may provide a clinically practical method for describing cardiorespiratory fitness.We computed e-CRF and tested its association with the FRS and CHD. Male participants (n=29,854) in the Aerobics Center Longitudinal Study (ACLS) who completed a baseline examination between 1979-2002 were followed for 12 years to determine incident CHD defined by self-report of myocardial infarction, revascularization, or CHD mortality. e-CRF was defined from a 7-item scale and categorized using age-specific tertiles. Multivariable survival analysis determined associations between FRS, e-CRF, and CHD. Interaction between e-CRF and FRS was tested by stratified analysis by 'low' and 'moderate or high' 10-year CHD risk. Men with high e-CRF were significantly (p-value b 0.0001) younger, and less likely to be smokers, compared to men with low e-CRF. Multivariable survival analysis reported men with high e-CRF were 29% (HR = 0.71; 95% 0.56, 0.88) less likely to experience a CHD event compared to men with low e-CRF. Stratified analyses showed men with 'low' 10-year FRS predicted CHD risk and high e-CRF had a 28% (HR = 0.72; 95% CI 0.57, 0.91) lower CHD-mortality risk compared to men with low e-CRF, no association was found in this group and men with moderate e-CRF. Men who were more fit had a decreased risk for CHD compared to men in the lowest third of fitness. Estimated CRF may add clinical value to the FRS and help clinicians better predict long-term CHD risk.

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Exercise and the Cardiovascular System

Cited by 611 publications

References 132 publications

Effect of Wave Reflection and Arterial Stiffness on the Risk of Development of Hypertension in Japanese Men

Effect of Wave Reflection and Arterial Stiffness on the Risk of Development of Hypertension in Japanese Men

Obesity and Cardiovascular Disease

Addition of Estimated Cardiorespiratory Fitness to the Clinical Assessment of 10-Year Coronary Heart Disease Risk in Asymptomatic Men

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